Biomedical subjects

Eva Hnizdo

Publications and source records attributed to Eva Hnizdo.

10 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↗

PubMed2005

Prevalence of asthma by industry in the US population: a study of 2001 NHIS data.

BACKGROUND: The estimated number of US workers potentially exposed to asthmagens ranges from 8 to 20 million. This study was undertaken to estimate the US prevalence of asthma in adults by industry of employment and to identify industries with elevated risk of asthma. METHODS: Prevalence analysis was performed on 20,991 adults, 18 years of age and older who participated in the 2001 National Health Interview survey. We used SUDAAN software to estimate the prevalence of self-reported physician diagnosed asthma by industry, and odds ratios (ORs) for asthma and industry adjusted for age, sex, race, and smoking status. RESULTS: The overall prevalence of physician diagnosed asthma was 6.5% (95% CI 6.1-6.9); 4.7% (95% CI 4.1-5.3) for males and 8.5% (95% CI 7.9-9.1) for females. In whites, the prevalence and ORs were significantly elevated for printing, publishing, and allied industries (OR = 2.4, 95% CI 1.2-5.0) and health care (OR = 1.3, 95% CI 1.0-1.7). In blacks, ORs were elevated for furniture, lumber, and wood (OR = 5.9, 95% CI 1.4-25.4) and entertainment and recreation industries (OR = 4.1, 95% CI 1.1-15.9). Other industries with elevated ORs included automobile dealers and gasoline station; durable goods; elementary, secondary schools, and colleges; other personal services; eating and drinking places; entertainment and recreation services; and utility and sanitary. CONCLUSIONS: Industries with elevated prevalence of asthma are identified. This information helps to target workplaces where detailed investigations for prevention and control may be appropriate.

Adolescent↗

PubMed2005

Risk of silicosis in cohorts of Chinese tin and tungsten miners, and pottery workers (I): an epidemiological study.

BACKGROUND: Epidemiological evaluations of the risk of silicosis in relation to exposure to crystalline silica have raised the question of whether different types of silica dust exposures vary with respect to their ability to cause silicosis. The aim of this study is to compare the risk of silicosis among cohorts of silica dust-exposed Chinese tin miners, tungsten miners, and pottery workers and to assess whether gravimetric measurements of respirable silica dust sufficiently determine the risk of silicosis or whether other factors of exposure may play a significant role. METHODS: Cohorts were selected from 20 Chinese mines and potteries. Inclusion criteria were starting employment after January 1, 1950 and being employed for at least 1 year during 1960-1974 in one of the selected workplaces. Radiological follow-up for silicosis onset was from January 1, 1950 through December 31, 1994. Silicosis was assessed according to the Chinese radiological criteria for diagnosis of pneumoconiosis (as suspect, Stage I, II, or III). Exposure-response relationships were estimated for silicosis of Stage I or higher. Silica dust exposure was estimated in terms of cumulative total dust exposure, calculated from a workplace, job title, and calendar year exposure matrix, and individual occupational histories. Cumulative total dust exposure was converted in two steps into cumulative respirable dust exposure and cumulative respirable silica dust exposure using conversion factors estimated from side-by-side measurements conducted in 1988-89. RESULTS: The male cohorts included 4,028 tin miners, 14,427 tungsten miners, and 4,547 pottery workers who had similar onset of employment and duration of follow-up. For a given exposure level, the risk of silicosis was higher for the tin and tungsten than the pottery workers. CONCLUSION: The observed differences in the risk of silicosis among the three cohorts suggest that silica dust characteristics, in addition to cumulative respirable silica dust exposure, may affect the risk of silicosis.

Adult↗

PubMed2004

Airflow obstruction attributable to work in industry and occupation among U.S. race/ethnic groups: a study of NHANES III data.

OBJECTIVES: To estimate the fraction of airflow obstruction attributable to workplace exposure by U.S. race/ethnic group. METHODS: U.S. population-based third National Health and Nutrition Examination Survey (NHANES III) data on 4,086 Caucasians, 2,774 African-Americans, and 2,568 Mexican-Americans, aged 30-75, were studied. Airflow obstruction was defined as FEV1/FVC<75% and FEV1<80% predicted. Weighted prevalence, and prevalence odds ratios (OR) adjusted for the effect of age, smoking status, pack-years, body mass index, education, and socio-economic status were estimated using SUDAAN software. RESULTS: Industries with the most cases of airflow obstruction attributable to workplace exposure include: armed forces; rubber, plastics, and leather manufacturing; utilities; textile mill manufacturing; health care; food products manufacturing; sales; construction; and agriculture. The fraction of cases with airflow obstruction associated with work in industry varied by race/ethnic group and was estimated as 22.2% (95% CI 9.1-33.4) among Caucasians, 23.4% (95% CI 2.2-40.0) among African-Americans, and 49.6% (32.1-62.6) among Mexican-Americans. CONCLUSIONS: This study found differences in the fraction of airflow obstruction cases associated with employment pattern among major U.S. race/ethnic population groups.

Adult↗

PubMed2004

Spray-painting and chronic airways obstruction.

BACKGROUND: The aim was to investigate the respiratory response of HDI-based paint aerosol within the context of the protection afforded by current exposure guidelines. METHODS: A cross-sectional study of 240 painters spraying polyurethane enamels was undertaken at four aircraft maintenance plants. Questionnaire and spirometric data were related to gravimetric measures of cumulative total and respirable paint aerosol (TPA and RPA) and estimated isocyanate in total and respirable aerosols (TIA and RIA). RESULTS: Average cumulative exposures in mg/m(3)-years +/- SD were 159.0 +/- 115.2 TPA, 19.1 +/- 13.8 RPA, 15.8 +/- 11.5 TIA, and 1.9 +/- 1.4 RIA. After adjusting for smoking and asthma symptoms, higher exposures were associated with statistically significant reduction in expiratory flowrates. Significant smoking-related reductions were also observed, without exposure interactions. CONCLUSIONS: These results suggest important respiratory effects from exposures to spray paint aerosols at levels generally in compliance with existing standards for otherwise unregulated particulates and for the isocyanate component of the paint.

Adult↗

PubMed2004

Longitudinal decline in lung function: evaluation of interleukin-10 genetic polymorphisms in firefighters.

During annual medical monitoring, some firefighters are found to have rates of decline in forced expiratory volume in one second (FEV1) far exceeding their peers. Interleukin-10 (IL-10) suppresses inflammation, and single nucleotide polymorphisms (SNPs) in the IL-10 gene may confer variable susceptibility to more rapid decline in lung function. In 1204 firefighters with at least six annual FEV1 measurements, increased age and greater initial FEV1 were associated with more rapid decline in lung function. DNA collected from 379 of these firefighters was screened for IL-10 SNPs at -1117, -854, 919, 1668, and 1812. A statistically significant difference in decline in lung function was found based on genotyping at the 1668 SNP. Evaluation of gene polymorphisms regulating lung inflammation may help to explain some of the variation in rate of decline in lung function in firefighters.

Adult↗

PubMed2004

New-onset asthma associated with exposure to 3-amino-5-mercapto-1,2,4-triazole.

OBJECTIVE: The authors conducted an investigation of a cluster of eight new-onset asthma cases identified in a chemical plant through the Sentinel Event Notification Systems for Occupational Risks (SENSOR) program. METHODS: Workplace investigation involved interviews with the asthma cases, review of medical records, and medical and industrial hygiene surveys in the plant. RESULTS: Altogether, 11 work-related asthma cases were identified among the plant workers-approximately 10% of the workers exposed to the potential causative agents: 3-amino-5-mercapto-1,2,4-triazole (AMT) or N-(2,6-difluorophenyl)-5-methyl-[1,2,4]triazolo[1,5-a]pyrimidine-2-sulfonamide (DE-498; trade name Flumetsulam). Of these cases, six had physician-diagnosed occupational asthma (OA) based on work-related respiratory symptoms and nonspecific bronchial hyperresponsiveness (NSBH), and of these, three had work-related expiratory peak flow changes. CONCLUSIONS: The findings of this investigation, together with findings from concurrent animal studies, suggest that this outbreak of new-onset asthma was associated with exposure to AMT. CLINICAL SIGNIFICANCE: A cluster of eight new-onset asthma cases was identified in a chemical plant through the SENSOR program. Subsequent workplace investigation identified AMT, used in the production of a herbicide N-(2,6-difluorophenyl)-5-methyl- [1,2,4]triazolo[1,5-a]pyrimidine-2-sulfonamide, as the most likely causal agent.

Asthma↗

PubMed2002

Association between chronic obstructive pulmonary disease and employment by industry and occupation in the US population: a study of data from the Third National Health and Nutrition Examination Survey.

Data from the US population-based Third National Health and Nutrition Examination Survey, conducted from 1988 to 1994, were used to estimate the population prevalence, prevalence odds ratios, and attributable fractions for the association of chronic obstructive pulmonary disease (COPD) with employment by industry and occupation. The aim was to identify industries and occupations at increased risk of COPD. COPD was defined as forced expiratory volume in 1 second (FEV(1))/forced vital capacity <70% and FEV(1 )<80% predicted. The authors used SUDAAN software (Research Triangle Institute, Research Triangle Park, North Carolina) to estimate the weighted population prevalence and odds ratios using 9,823 subjects aged 30-75 years who underwent lung function tests. Odds ratios for COPD, adjusted for age, smoking status, pack-years of smoking, body mass index, education, and socioeconomic status, were increased for the following industries: rubber, plastics, and leather manufacturing; utilities; office building services; textile mill products manufacturing; the armed forces; food products manufacturing; repair services and gas stations; agriculture; sales; construction; transportation and trucking; personal services; and health care. Occupations associated with increased odds ratios for COPD were freight, stock, and material handlers; records processing and distribution clerks; sales; transportation-related occupations; machine operators; construction trades; and waitresses. The fraction of COPD attributable to work was estimated as 19.2% overall and 31.1% among never smokers.

Adult↗

PubMed2002

Development of quantitative exposure data for a pooled exposure-response analysis of 10 silica cohorts.

BACKGROUND: Comprehensive quantitative silica exposure estimates over time, measured in the same units across a number of cohorts, would make possible a pooled exposure-response analysis for lung cancer. Such an analysis would help clarify the continuing controversy regarding whether silica causes lung cancer. METHODS: Existing quantitative exposure data for 10 silica-exposed cohorts were retrieved from the original investigators. Occupation- and time-specific exposure estimates were either adopted/adapted or developed for each cohort, and converted to milligram per cubic meter (mg/m(3)) respirable crystalline silica. RESULTS: Quantitative exposure assignments were typically based on a large number (thousands) of raw measurements, or otherwise consisted of exposure estimates by experts (for two cohorts). Median exposure level of the cohorts ranged between 0.04 and 0.59 mg/m(3) respirable crystalline silica. Exposure estimates were partially validated via their successful prediction of silicosis in these cohorts. CONCLUSIONS: Existing data were successfully adopted or modified to create comparable quantitative exposure estimates over time for 10 silica-exposed cohorts, permitting a pooled exposure-response analysis. The difficulties encountered in deriving common exposure estimates across cohorts are discussed.

Cohort Studies↗