Search

The article discusses a study on the impact of body mass index (BMI) on health status among adults with asthma. Studies associate obesity with a higher risk for developing adult-onset asthma. Results of the study showed that the generic physical status was worse in the overweight group compared to the normal BMI group. The study notes the need for clinicians to counsel dietary modification and weight loss for their overweight and obese patients with asthma.

Purpose: HIV is associated with chronic obstructive pulmonary disease (COPD) in high resource settings. Similar relationships are less understood in low resource settings. We aimed to estimate the association between HIV infection, tuberculosis, and COPD in rural Uganda.Methods: The Uganda Non-communicable Diseases and Aging Cohort study observes people 40 years and older living with HIV (PLWH) on antiretroviral therapy, and population-based HIV-uninfected controls in rural Uganda. Participants completed respiratory questionnaires and post-bronchodilator spirometry.Results: Among 269 participants with spirometry, median age was 52 (IQR 48–55), 48% (n = 130) were ever-smokers, and few (3%, n = 9) reported a history of COPD or asthma. All participants with prior tuberculosis (7%, n = 18) were PLWH. Among 143 (53%) PLWH, median CD4 count was 477 cells/mm3 and 131 (92%) were virologically suppressed. FEV1 was lower among older individuals (− 0.5%pred/year, 95% CI 0.2–0.8, p < 0.01) and those with a history of tuberculosis (− 14.4%pred, 95% CI − 23.5 to − 5.3, p < 0.01). COPD was diagnosed in 9 (4%) participants, eight of whom (89%) were PLWH, six of whom (67%) had a history of tuberculosis, and all of whom (100%) were men. Among 287 participants with complete symptom questionnaires, respiratory symptoms were more likely among women (AOR 3.9, 95% CI 2.0–7.7, p < 0.001) and those in homes cooking with charcoal (AOR 3.2, 95% CI 1.4–7.4, p = 0.008).Conclusion: In rural Uganda, COPD may be more prevalent among PLWH, men, and those with prior tuberculosis. Future research is needed to confirm these findings and evaluate their broader impacts on health. [ABSTRACT FROM AUTHOR]

Background: There is considerable debate about the benefits and risks of electronic cigarettes (ECs). To better understand the risk-benefit ratio of ECs, more information is needed about net nicotine consumption and toxicant exposure of cigarette smokers switching to ECs.Methods: Forty cigarette smokers (≥1 year of smoking) interested in switching to ECs but not necessarily quitting smoking were enrolled in a 4-week observational study and provided an e-Go C non-variable battery and refillable atomizers and choice of eight flavors in 12 or 24 mg nicotine dosage. Measurement of urinary cotinine (metabolite of nicotine), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL; a pulmonary carcinogen), and eight volatile organic compounds (VOCs) that are toxic tobacco smoke constituents was conducted at baseline and week 4.Results: All participants with follow-up data (92.5%) reported using the study EC. Of the 40 smokers, 16 reported no cigarettes at week 2 (40%) and six continued to report no cigarettes at week 4 (15%). Change in nicotine intake over the 4 weeks was non-significant (p = .90). Carbon monoxide (p < .001), NNAL (p < .01) and metabolites of benzene (p < .01) and acrylonitrile (p = .001) were significantly decreased in the study sample. Smokers switching exclusively to ECs for at least half of the study period demonstrated significant reductions in metabolites of ethylene oxide (p = .03) and acrylamide (p < .01).Conclusion: Smokers using ECs over 4 weeks maintained cotinine levels and experienced significant reductions in carbon monoxide, NNAL, and two out of eight measured VOC metabolites. Those who switched exclusively to ECs for at least half of the study period significantly reduced two additional VOCs.Implications: This study extends current literature by measuring change in smoking dependence and disease-associated biomarkers, NNAL and a panel of eight common VOCs that are toxic tobacco smoke constituents in smokers who switch to ECs. The findings support the idea of harm reduction, however some levels of toxicant exposure are still of clinical concern, particularly for dual users. Extrapolation of these results must be careful to separate the different toxic exposure results for exclusive switchers versus dual cigarette + EC users, and not to equate harm reduction with the idea that using ECs is harmless. [ABSTRACT FROM AUTHOR]

Background: The global prevalence of chronic obstructive pulmonary disease (COPD) is expected to increase and the disease is projected to be the third leading cause of death by the year 2020. The purpose of this study was to measure the prevalence and determine the risk factors for COPD in Canada. Methods: This is a cross-sectional study that uses data from a nationally generalizable survey, the Canadian Community Health Survey, 2014. There were 46,924 respondents aged 35 years or older. Uni- and multi-variate logistic regression analyses were conducted to determine the risk factors associated with COPD. Results: The overall prevalence of COPD in the surveyed population was 5.69%. Results from multivariate logistic regression showed that COPD was significantly higher among individuals who were 65 years or older (odds ratio [OR] =4.43; 95% confidence interval [CI]: 3.69-5.33), current smokers (OR = 5.13; 95% CI: 4.43-5.95), underweight or obese by body mass index ([OR = 1.81; 95% CI: 1.38-2.38] and [OR = 1.58; 95% CI: 1.41-1.77], respectively), with a total personal income of <$20,000 (OR = 3.67; 95% CI: 2.95-4.57,), and some postsecondary education (OR = 1.42; 95% CI: 1.14-1.76). Immigrants were less likely to have COPD compared to Canadian-born respondents (OR = 0.67; 95% CI: 0.57-0.79). Conclusions: COPD is a growing and serious public health issue in Canada. The risk factors identified in this study provide useful targets to health promotion and education initiatives, health-care providers, and public health organizations to decrease the prevalence of COPD. [ABSTRACT FROM AUTHOR]

Secondhand smoke (SHS) causes approximately 50,000 deaths per year. Despite all the health warnings, smoking is still allowed indoors in many states exposing both workers and patrons to SHS on a daily basis. The opponents of smoking bans suggest that present day air filtration systems remove the health hazards of exposure to SHS. In this study, using an acute SHS exposure model, we looked at the impact of commonly used air filters (MERV-8 pleated and MERV-8 pleated activated charcoal) on SHS by assessing the inflammatory response and the oxidative stress response in C57BL/6 mice. In order to assess the inflammatory response, we looked at the tumor necrosis factor alpha (TNF-α) cytokine production by alveolar macrophages (AMs), and for the oxidative response, we quantified the products of lipid peroxidation and the total glutathione (tGSH) production in lung homogenates. Our results showed that SHS caused significant immune and oxidative stress responses. The tested filters resulted in only a modest alleviation of inflammatory and oxidative responses due to SHS exposure. Our data show that these air filters cannot eliminate the risk of SHS exposure and that a short-term exposure to SHS is sufficient to alter the inflammatory cytokine response and to initiate a complex oxidative stress response. Our results are consistent with the statement made by the Surgeon General’s reports that there is no risk free level of exposure to SHS. [ABSTRACT FROM PUBLISHER]

Background Mild asthmatics who smoke cigarettes may develop unstable disease and neutrophilic infiltration of the airways, features more usually associated with severe asthmatic disease. The mechanisms giving rise to this response remain unclear. Objective To address the hypothesis that smoking increases bronchial mucosal production of IL-17A which acts on bronchial epithelial cells directly and in concert with other environmental stimuli to induce the production of IL-6 and neutrophil chemotaxins. Methods IL-17A, IL-8, IL-6, neutrophils and eosinophils were detected and quantified by immunohistochemistry in endobronchial biopsy sections from smoking and non-smoking asthmatics. Human tracheal epithelial cells ( HTEpC) were cultured with IL-17A in the presence/absence of cigarette smoke extract ( CSE) and aeroallergens lacking intrinsic protease activity, and IL-6 and IL-8 production measured in vitro. Results Expression of IL-17A, IL-6 and IL-8 and neutrophil numbers was significantly elevated in the bronchial mucosa of the asthmatic smokers compared to the non-smokers. Expression of IL-17A correlated with that of IL-8 and neutrophil numbers. In the smoking asthmatics, eosinophil numbers also correlated with expression of IL-8 and IL-17A. Exposure of HTEpC cells to both CSE and IL-17A increased expression of IL-6 and IL-8 in a concentration-dependent and synergistic manner. Co-stimulation with CSE, IL-17A and aeroallergens further increased IL-6 and IL-8 production synergistically. Conclusions The data support the hypothesis that asthmatic smokers develop neutrophilic inflammation of the airways propagated at least partly by smoke-induced production of IL-17A which together with smoke and other environmental stimuli acts on airways epithelial cells to induce neutrophil chemotaxins. [ABSTRACT FROM AUTHOR]

Background Exposure to respirable crystalline silica (RCS) causes emphysema, airflow limitation and chronic obstructive pulmonary disease (COPD). Slate miners are exposed to slate dust containing RCS but their COPD risk has not previously been studied. Aims To study the cumulative effect of mining on lung function and risk of COPD in a cohort of Welsh slate miners and whether these were independent of smoking and pneumoconiosis. Methods The study was based on a secondary analysis of Medical Research Council (MRC) survey data. COPD was defined as forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) ratio <0.7. We created multivariable models to assess the association between mining and lung function after adjusting for age and smoking status. We used linear regression models for FEV1 and FVC and logistic regression for COPD. Results In the original MRC study, 1255 men participated (726 slate miners, 529 unexposed non-miners). COPD was significantly more common in miners (n = 213, 33%) than non-miners (n = 120, 26%), P < 0.05. There was no statistically significant difference in risk of COPD between miners and non-miners when analysis was limited to non-smokers or those without radiographic evidence of pneumoconiosis. After adjustment for smoking, slate mining was associated with a reduction in%predicted FEV1 [β coefficient = -3.97, 95% confidence interval (CI) -6.65, -1.29] and FVC (β coefficient = -2.32, 95% CI -4.31, -0.33) and increased risk of COPD (odds ratio: 1.38, 95% CI 1.06, 1.81). Conclusions Slate mining may reduce lung function and increase the incidence of COPD independently of smoking and pneumoconiosis. [ABSTRACT FROM AUTHOR]

Although only less than one-third of smokers develop COPD, early marker(s) of COPD development are lacking. The aim of this research was to assess the ability of an average equilibrium exhaled breath temperature (EBT) in identifying susceptibility to cigarette smoke so as to predict COPD development in smokers at risk. The study was a part of a multicenter prospective cohort study in current smokers (N = 140, both sexes, 40–65 years, ≥20 pack-years) with no prior diagnosis of COPD. Diagnostic workup includes history, physical, quality of life, hematology and highly sensitive CRP, EBT before and after smoking a cigarette, lung function with bronchodilator test, and 6-minute walk test. Patients without a diagnosis of COPD and in GOLD 1 stage at initial assessment were reassessed after 2 years. COPD was additionally diagnosed based on lower level of normal (LLN) lung function criteria. Utility of EBT for disease progression was analyzed using receiver operator curve (ROC) and logistic regression analyses. Change in EBT after smoking a cigarette at initial visit (ΔEBT) was significantly predictive for disease progression (newly diagnosed COPD; newly diagnosed COPD + severity progression) after 2 years (p< 0.05 for both). ΔEBT had an AUC of 0.859 (p= 0.011) with sensitivity of 66.7% and specificity of 98.1% for newly diagnosed COPD using LLN criteria. We conclude that EBT shows potential for predicting the future development of COPD in current smokers. This was best seen using LLN to diagnose COPD, adding further evidence to question the use of GOLD criteria for diagnosing COPD. [ABSTRACT FROM PUBLISHER]

Background and Purpose: Chronic obstructive pulmonary disease (COPD) is a major cause of illness and death, often induced by cigarette smoking (CS). It is characterized by pulmonary inflammation and fibrosis that impairs lung function. Existing treatments aim to control symptoms but have low efficacy, and there are no broadly effective treatments. A new potential target is the ectoenzyme, semicarbazide-sensitive mono-amine oxidase (SSAO; also known as vascular adhesion protein-1). SSAO is elevated in smokers' serum and is a pro-inflammatory enzyme facilitating adhesion and transmigration of leukocytes from the vasculature to sites of inflammation.Experimental Approach: PXS-4728A was developed as a low MW inhibitor of SSAO. A model of COPD induced by CS in mice reproduces key aspects of human COPD, including chronic airway inflammation, fibrosis and impaired lung function. This model was used to assess suppression of SSAO activity and amelioration of inflammation and other characteristic features of COPD.Key Results: Treatment with PXS-4728A completely inhibited lung and systemic SSAO activity induced by acute and chronic CS-exposure. Daily oral treatment inhibited airway inflammation (immune cell influx and inflammatory factors) induced by acute CS-exposure. Therapeutic treatment during chronic CS-exposure, when the key features of experimental COPD develop and progress, substantially suppressed inflammatory cell influx and fibrosis in the airways and improved lung function.Conclusions and Implications: Treatment with a low MW inhibitor of SSAO, PXS-4728A, suppressed airway inflammation and fibrosis and improved lung function in experimental COPD, demonstrating the therapeutic potential of PXS-4728A for this debilitating disease. [ABSTRACT FROM AUTHOR]

Background: Smoking has a detrimental effect on the symptoms and severity of asthma, a common chronic disease among adolescents. The purpose of this study was to examine the association between asthma and smoking among high school students and assess provider-patient communication with asthmatic adolescents regarding smoking and adolescents' beliefs about the harms of smoking.Methods: In fall 2014, data from high school students, ages 14-18 years, completing the 2009-2010 Virginia Youth Tobacco Survey (N = 1796) were used in descriptive analyses and multivariable logistic regression models adjusting for model-specific confounders as appropriate.Results: Overall, an estimated 19 % of high school students in Virginia smoked and 16 % had asthma. Odds of smoking did not differ by asthma status; however, asthmatics had 1.5 times higher odds of being asked if they smoke (95 % CI 1.06-2.13) and being advised not to smoke by a health professional (95 % CI 1.10-2.14) compared to non-asthmatics. Asthmatics who believed second-hand smoke or smoking 1-5 cigarettes/day was not harmful had respectively 4.2 and 2.8 times higher odds of smoking than those who thought each was harmful. Further, asthmatics who thought smoking 1-2 years is safe had 3.4 times higher odds of smoking than those who did not (95 % CI 1.57-10.1).Conclusions: While asthmatic adolescents are just as likely to smoke as non-asthmatics, less healthy beliefs about the risks of smoking increase the odds of smoking among asthmatics. Thus, targeted asthma-specific smoking prevention and education to change attitudes and beliefs could be an effective tool for adolescents. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this research was to examine the occupational risk factors for Chronic Obstructive Pulmonary Diseases (COPD) in a range of occupations. Methods: Eleven occupations involving different types of exposure were observed in this multicenter case-control study. Controls and cases were matched for sex, age and smoking. Multiple logistic regression analyses were used to estimate odds ratios (ORs). Results: A total of 1,519 participants were initially recruited between September 2004 and September 2012. After matching, 547 pairs were obtained. The mean age was 56.3 +/- 10.4 years. Smelter workers were the only ones with an increased risk of COPD in this study (OR = 7.6, p < 0.0001, 95% CI [4.5, 12.9]). Physical activity was protective (OR = 0.7), while living in the city was a risk (OR = 1.6). The main used metals were cast iron, aluminum and alloys. Molds and cores were mainly made from sand and synthetic resins. Machine maintenance (65.2%), molding (49.6%), finishing (41.1%) and casting (41.0%) were the most common activities. Almost all workers (95.1%) cleaned the floors and machines with a brush or compressed air. Conclusions: This study demonstrates the importance of occupational factors in the genesis of COPD, especially among smelter workers. As with the fight against smoking-related disease, the removal or substitution of recognized hazardous agents is the best way of preventing the onset of COPD. This is why it is essential to continue research on its occupational risk factors. [ABSTRACT FROM AUTHOR]

Purpose: Chronic obstructive pulmonary disease (COPD) is increasing in prevalence and mortality. This study evaluated the prevalence, risk factors, characteristics, and health-related quality of life (HRQoL) of COPD among nonsmokers in Korea. Methods: This was a population-based cross-sectional study using data obtained from the Fourth and Fifth Korean National Health and Nutrition Examination Survey, which was conducted from 2007 to 2011. Results: A total of 15,063 participants completely answered the questionnaire and performed the spirometry. Among them, 59.6 % were nonsmokers and 40.4 % were smokers. The prevalence of nonsmoker COPD was 7.1 %. On multivariate analysis, age ≥65 years (OR, 2.93; 95 % CI, 2.44-3.51), male sex (OR, 2.98; 95 % CI, 2.40-3.71), living in rural area (OR, 1.26; 95 % CI, 1.05-1.51), lower body mass index (BMI) (<18.5 kg/m) (OR, 3.00; 95 % CI, 1.78-5.01), self-reported asthma (OR, 2.72; 95 % CI, 2.05-3.60), and self-reported tuberculosis (OR, 4.73; 95 % CI, 3.63-6.17) showed a significantly higher risk of nonsmoker COPD. Analysis of nonsmoker and smoker COPD revealed that there are more females in nonsmoker COPD patients (73.9 vs. 6.9 %, P < 0.001). Nonsmoker COPD patients presented with impaired mobility, pain/discomfort, and anxiety/depression functions as well as a lower mean EuroQol Five-Dimension Questionnaire utility score, which showed HRQoL. Conclusions: The burden of nonsmoker COPD was considerable. Older age, male sex, lower BMI, self-reported asthma, and self-reported tuberculosis were risk factors for nonsmoker COPD and there were differences between nonsmoker and smoker COPD in terms of sex, comorbidities, and HRQoL. [ABSTRACT FROM AUTHOR]

Background: Second-hand smoke (SHS) exposure has been linked to the development of and morbidity from lung disease. We sought to advance understanding of the impact of SHS on health-related outcomes in individuals with COPD.Methods: Among the participants with COPD in SPIROMICS, recent SHS exposure was quantified as (1) hours of reported exposure in the past week or (2) reported living with a smoker. We performed adjusted regression for SHS with outcomes, testing for interactions with gender, race, smoking and obesity.Results: Of the 1580 participants with COPD, 20% reported living with a smoker and 27% reported exposure in the past week. Living with a smoker was associated with worse St George's Respiratory Questionnaire score (SGRQ, β 3.10; 95% CI 0.99 to 5.21), COPD Assessment Test score (β 1.43; 95% CI 0.52 to 2.35) and increased risk for severe exacerbations (OR 1.51, 95% CI 1.04 to 2.17). SHS exposure in the past week was associated with worse SGRQ (β 2.52; 95% CI 0.47 to 4.58), nocturnal symptoms (OR 1.58; 95% CI 1.19 to 2.10), wheezing (OR 1.34; 95% CI 1.02 to 1.77), chronic productive cough (OR 1.77; 95% CI 1.33 to 2.35) and difficulty with cough and sputum (Ease of Cough and Sputum scale, β 0.84; 95% CI 0.42 to 1.25). SHS was associated with increased airway wall thickness on CT but not emphysema. Active smokers, obese individuals and individuals with less severe airflow obstruction also had higher susceptibility to SHS for some outcomes.Conclusion: Individuals with COPD, including active smokers, have significant SHS exposure, associated with worse outcomes and airway wall thickness. Active smokers and obese individuals may have worse outcomes associated with SHS.Trial Registration Number: NCT01969344 (clinicaltrials.gov). [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives This study compares forced vital capacity (FVC) and Forced Expiratory Volume at 1 Second (FEV1) of Tibetans with those of Han who were born and raised at high altitude. Materials and Methods FVC and FEV1 tests were conducted among 1,063 children and adolescents between the ages of 6 and 20 years, and 184 adults between the ages of 21 and 39 years who had lived their entire lives at 3200 m, 3800 m and 4300 m in Qinghai Provence, Peoples Republic of China. Results Even though FVC and FEV1 values of Han born and raised at high altitude are generally lower than those of Tibetans through age 15 in girls and age 16 in boys, differences are largely explained by variation in stature (height-squared) and chest circumference. Among older adolescents and adults, the FVC and FEV1 values of Tibetans are significantly larger than those of Han born and raised at high altitude; and are much larger than would be predicted, based on stature and chest circumference. Discussion These results indicate that the large FVC and FEV1 values of Tibetan adults develop primarily from an accelerated pattern of lung growth that begins during mid-to-late adolescence and possibly extends into young adulthood. This developmental pattern is not only distinct from that of Han born and raised at high altitude, but also from those of Andean Quechua and Aymara. The pace of lung function growth may therefore represent another feature distinguishing the Tibetan from the Andean pattern of adaptation to high altitude hypoxia. Because of this, a search for features in the Tibetan genome related to this lung function growth phenotype might be productive and important. Am J Phys Anthropol 159:244-255, 2016. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

It is estimated that the world population will reach a record 7.3 billion in 2015, and the high burden of chronic conditions associated with ageing and smoking will increase further. Respiratory diseases in general receive little attention and funding in comparison with other major causes of global morbidity and mortality. In particular, chronic obstructive pulmonary disease ( COPD) has been a major public health problem and will remain a challenge for clinicians within the 21st century. Worldwide, COPD is in the spotlight, since its high prevalence, morbidity and mortality create formidable challenges for health-care systems. This review emphasizes the magnitude of the COPD problem from a clinician's standpoint by drawing extensively from the new findings of the Global Burden of Disease study. Updated, distilled information on the population distribution of COPD is useful for the clinician to help provide an appreciation of the relative impact of COPD in daily practice compared with other chronic conditions, and to allocate minimum resources in anticipation of future needs in care. Despite recent trends in reduction of COPD standardized mortality rates and some recent successes in anti-smoking efforts in a number of Western countries, the overarching demographic impact of ageing in an ever-expanding world population, joined with other factors such as high rates of smoking and air pollution in Asia, will ensure that COPD will continue to pose an ever-increasing problem well into the 21st century. [ABSTRACT FROM AUTHOR]

COPD is a major cause of emergency admissions worldwide. In many countries the majority of COPD care is provided by primary care teams. This study examined variation between primary care teams in rates of COPD admission and assessed the role of prevalence, deprivation, practice performance, and general practitioner (GP) and nurse supply on risk of COPD admission. Retrospective observational study of National Health Service admissions for COPD of patients registered with London general practices over four years (2006–2009). We sought associations using negative binomial regression between COPD admissions and population factors, practice organization and practice performance. Trends in rates of COPD admissions across London were stable between 2006 and 2009. COPD admission rates varied substantially between practices (2006/7: median 13.68/10,000 population (IQR 7.83–22.70)), with almost a 3-fold difference across the interquartile range each year. Practice characteristics varied to a similar extent. Variation in practice COPD admission rates was associated with diagnosed prevalence of COPD (Rate Ratio 2.06, 95% CI 1.84–2.3) and increasing levels of deprivation (RR 1.01, 1.006–1.01). Other practice characteristics, including GP and nurse supply, and practice performance scores were not predictive of practice level COPD admission rates, when controlling for COPD prevalence and socio-economic status. Main predictors of variation in rates of COPD admissions were prevalence of diagnosed COPD and socioeconomic status. The absence of evidence that variation in primary care services for COPD was associated with rates of COPD admission emphasizes the importance of primary prevention of COPD if COPD admission rates are to fall. [ABSTRACT FROM PUBLISHER]

Background While smoking is the major cause of chronic obstructive pulmonary disease (COPD), occupational exposures to vapors, gases, dusts, and fumes (VGDF) increase COPD risk. This case-control study estimated the risk of COPD attributable to occupational exposures among construction workers. Methods The study population included 834 cases and 1243 controls participating in a national medical screening program for older construction workers between 1997 and 2013. Qualitative exposure indices were developed based on lifetime work and exposure histories. Results Approximately 18% (95%CI = 2-24%) of COPD risk can be attributed to construction-related exposures, which are additive to the risk contributed by smoking. A measure of all VGDF exposures combined was a strong predictor of COPD risk. Conclusions Construction workers are at increased risk of COPD as a result of broad and complex effects of many exposures acting independently or interactively. Control methods should be implemented to prevent worker exposures, and smoking cessation should be promoted. Am. J. Ind. Med. 58:1083-1097, 2015. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objective To describe how the original American full-length version of the Test of Functional Health Literacy in Adults ( TOFHLA) was translated and adapted for use in the Danish setting and culture. A reliable Danish version of the TOFHLA was created and pretested using patients diagnosed with chronic obstructive pulmonary disease ( COPD) as case group. Methods Forty-two patients with COPD completed the Danish TOFHLA and participated in a face-to-face interview concerning their basic demographics. Statistical analyses were conducted to explore the demographic data provided by the participants and to determine the internal consistency and reliability of the Danish TOFHLA. Results The mean age of sample was 68.7 years (range 34-86). The face validity, internal consistency and item to scale correlations of the Danish TOFHLA were determined and found to fulfil well-established criteria; on this basis, we found the reliability and consistency of the Danish TOFHLA to be satisfying. Conclusion The Danish TOFHLA is now ready for application in future research projects, which test levels of functional health literacy in an elderly Danish population at risk of chronic diseases. The evolvement in the measurement of health literacy is still ongoing, as there is a need to refine existing methods. Until recently, there has been a total lack of instruments for assessing health literacy in Scandinavia; it is hoped that this development of the Danish TOFHLA will promote further research within the field of health literacy in Scandinavia and other European countries. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) is characterized by an interaction of various environmental influences especially cigarette smoking and genetic determinants. The prevalence of this disease is ever increasing and characterization of the genetic determinants of the disease has been undertaken globally. The 'A disintegrin and metalloprotease 33' (ADAM 33) gene is one candidate gene that has been studied. Objective: Our objective was to investigate whether single nucleotide polymorphisms in ADAM33 gene are associated with COPD in long-term tobacco smokers in the ethnic Kashmiri population of northern India. Materials and Methods: This was a randomized case-control study, which included 78 stable COPD (GOLD stage11-IV) patients, who were compared with 77 age- and sex-matched long-term tobacco smokers (>20 pack years) without any evidence of COPD. Polymorphic analysis for three single nucleotide polymorphisms (SNPs), (T1, T2, and Q1) of the ADAM33 gene was done by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) followed by sequencing. The data were analyzed by descriptive statistics and comparative evaluation was done by parametric/ non-parametric tests. Results: The analysis of the T1, T2, and Q1 SNPs, revealed that the frequencies of the T2GG, T1GG, and the Q1AG genotypes were significantly higher in patients with COPD in comparison with the controls (P < 0.001). Similarly, the T1G and T2G allele frequency was higher in the patients than in the controls (p=0.177 and 0.43, respectively). Conclusion: Three SNPs of the ADAM33 gene were significantly associated with COPD in the Kashmiri population of India. This study establishes the possible role of ADAM33 SNPS in the causation of COPD. Further studies across different geographical areas in the country will unravel the contribution of this gene in the causation of COPD in India. [ABSTRACT FROM AUTHOR]

Objective: The recent increase in asthma prevalence is thought to be partially due to environmental changes such as changes in air pollution and occupational exposures. Nationally representative information on workplace exposures among US adults with asthma is limited. Methods: We examined 2010 National Health Interview Survey data to determine the proportion of employed adults with asthma who had frequent workplace exposures. Results: Among adults with current asthma, 19.6% frequently worked outdoors, 17.5% were frequently exposed to workplace secondhand smoke and 28.1% were frequently exposed to workplace vapors, gas, dust or fumes. Adults ever told by a health professional that asthma is probably work-related, when compared to adults who were not, had increased odds of frequent work outdoors [prevalence odds ratio (POR) = 2.76], frequent workplace exposure to secondhand smoke (POR = 3.08) and frequent workplace exposure to vapors, gas, dust or fumes (POR = 3.56). Conclusions: To our knowledge, this is the first population-based study in USA that estimates the proportion of working adults with asthma that have frequent workplace exposures. Increasing the understanding of workplace exposures among adults with asthma will help enable prevention of asthma through workplace exposure reduction or avoidance. Future studies should further examine industries and occupations of individuals with asthma and frequent workplace exposures. [ABSTRACT FROM AUTHOR]

Aims and objectives To compare a functioning assessment based on the International Classification of Functioning, Disability and Health ( ICF) with a conventional medical assessment, in terms of their respective consequences for health professionals' clinical decision-making and the fit with patient's own perspective of health. Background In chronic diseases, pathogenic-oriented health care falls short in generating all the information required for determining healthcare provision to improve health. A broader, so-called salutogenic approach, by using the ICF, focusing on how to stay healthy, rather than on what causes diseases, seems more appropriate. Design A cross-sectional comparative study using data from a randomised controlled trial. Methods Data about patient problems and professional healthcare activities were collected from a total of 81 patients with severe multiple sclerosis who were randomly assigned to one of two groups: the ICF group, assessed with a functioning assessment ( n = 43), and the medical group, assessed with a conventional medical assessment ( n = 38). Data were analysed statistically using descriptive and inferential statistics. Results A functioning assessment resulted in the registration of significantly more patient problems in the health components 'participation' and 'environmental factors', as well as significantly more professional healthcare activities befitting these components. The ICF group had a significant positive correlation between registered problems by health professionals and patients' self-reported problems, whereas the medical group had several negative correlations. Conclusion A functioning assessment resulted in a care plan that not only was broader and more complete but also reflected the patients' self-reported problems more closely than a medical assessment, without a loss of focus on medical problems. Relevance to clinical practice This study has shown that some health problems remain unnoticed by a medical assessment alone, which is especially important for the chronically ill. A functioning assessment provides a strong foundation for identifying all relevant information related to health. [ABSTRACT FROM AUTHOR]

Background: Cigarette smoking is associated with increased frequency and duration of viral respiratory infections, but the underlying mechanisms are incompletely defined. We investigated whether smoking reduces expression by human lung macrophages (Mø) of receptors for viral nucleic acids and, if so, the effect on CXCL10 production. Methods: We collected alveolar macrophages (AMø) by bronchoalveolar lavage of radiographically-normal lungs of subjects undergoing bronchoscopies for solitary nodules (n = 16) and of volunteers who were current or former smokers (n = 7) or never-smokers (n = 13). We measured expression of mRNA transcripts for viral nucleic acid receptors by real-time PCR in those AMø and in the human Mø cell line THP-1 following phorbol myristate acetate/ vitamin D3 differentiation and exposure to cigarette smoke extract, and determined TLR3 protein expression using flow cytometry and immunohistochemistry. We also used flow cytometry to examine TLR3 expression in total lung Mø from subjects undergoing clinically-indicated lung resections (n = 25). Of these, seven had normal FEV1 and FEV1/FVC ratio (three former smokers, four current smokers); the remaining 18 subjects (14 former smokers; four current smokers) had COPD of GOLD stages I-IV. We measured AMø production of CXCL10 in response to stimulation with the dsRNA analogue poly(I:C) using Luminex assay. Results: Relative to AMø of never-smokers, AMø of smokers demonstrated reduced protein expression of TLR3 and decreased mRNA for TLR3 but not TLR7, TLR8, TLR9, RIG-I, MDA-5 or PKR. Identical changes in TLR3 gene expression were induced in differentiated THP-1 cells exposed to cigarette smoke-extract in vitro for 4 hours. Among total lung Mø, the percentage of TLR3-positive cells correlated inversely with active smoking but not with COPD diagnosis, FEV1% predicted, sex, age or pack-years. Compared to AMø of never-smokers, poly(I:C)-stimulated production of CXCL10 was significantly reduced in AMø of smokers. Conclusions: Active smoking, independent of COPD stage or smoking duration, reduces both the percent of human lung Mø expressing TLR3, and dsRNA-induced CXCL10 production, without altering other endosomal or cytoplasmic receptors for microbial nucleic acids. This effect provides one possible mechanism for increased frequency and duration of viral lower respiratory tract infections in smokers. Trial registration: ClinicalTrials.gov NCT00281190, NCT00281203 and NCT00281229. [ABSTRACT FROM AUTHOR]

Context: Electronic cigarettes (e-cigarettes) are becoming increasingly popular yet their effects on health remain unknown. Objective: To conduct the first comprehensive and standardized assessment of the acute impact of active and passive e-cigarette smoking on serum cotinine and lung function, as compared to active and passive tobacco cigarette smoking. Materials and methods: Fifteen smokers (≥15 cigarettes/day; seven females; eight males) and 15 never-smokers (seven females; eight males) completed this repeated-measures controlled study. Smokers underwent a control session, an active tobacco cigarette (their favorite brand) smoking session and an active e-cigarette smoking session. Never-smokers underwent a control session, a passive tobacco cigarette smoking session and a passive e-cigarette smoking session. Serum cotinine, lung function, exhaled carbon monoxide and nitric oxide were assessed. The level of significance was set at p ≤ 0.001 to adjust for multiple comparisons. Results: e-Cigarettes and tobacco cigarettes generated similar ( p > 0.001) effects on serum cotinine levels after active (60.6 ± 34.3 versus 61.3 ± 36.6 ng/ml) and passive (2.4 ± 0.9 versus 2.6 ± 0.6 ng/ml) smoking. Neither a brief session of active e-cigarette smoking (indicative: 3% reduction in FEV1/FVC) nor a 1 h passive e-cigarette smoking (indicative: 2.3% reduction in FEV1/FVC) significantly affected the lung function ( p > 0.001). In contrast, active (indicative: 7.2% reduction in FEV1/FVC; p < 0.001) but not passive (indicative: 3.4% reduction in FEV1/FVC; p = 0.005) tobacco cigarette smoking undermined lung function. Conclusion: Regarding short-term usage, the studied e-cigarettes generate smaller changes in lung function but similar nicotinergic impact to tobacco cigarettes. Future research should target the health effects of long-term e-cigarette usage, including the effects of nicotine dosage. [ABSTRACT FROM AUTHOR]

Introduction There is growing interest in preventable, non-smoking causes of chronic obstructive pulmonary disease (COPD), among which are chronic exposures to respiratory irritants in the workplace. Sources of data Reviews of occupational COPD in specific occupations and industries and in general populations; supplemented with other or more recently published material. Areas of agreement There is good evidence for an increased risk of COPD from certain specific exposures (coal mine dust, silica, welding fume, textile dust, agricultural dust, cadmium fume). Areas of controversy Less clear is the causal role of non-specific dusts or fumes/gases in general populations where the available literature is notably uncritical. Growing points Other specific exposures, such as diesel fume; interactions between specific exposures and cigarette smoking; the development of safe working limits. Areas timely for developing research Occupations with large numbers of exposed employees, particularly in low-income countries. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Industrial Hygiene & Toxicology / Arhiv za Higijenu Rada I Toksikologiju is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this chapter we review the epidemiology of lung cancer incidence and mortality among never smokers/nonsmokers and describe the never smoker lung cancer risk models used by the Cancer Intervention and Surveillance Network (CISNET) modelers. Our review focuses on those influences likely to have measurable population impact on never smoker risk, such as secondhand smoke, even though the individual-level impact may be small. Occupational exposures may also contribute importantly to the population attributable risk of lung cancer. We examine the following risk factors in this chapter: age, environmental tobacco smoke, cooking fumes, ionizing radiation including radon gas, inherited genetic susceptibility, selected occupational exposures, preexisting lung disease, and oncogenic viruses. We also compare the prevalence of never smokers between the three CISNET smoking scenarios and present the corresponding lung cancer mortality estimates among never smokers as predicted by a typical CISNET model. [ABSTRACT FROM AUTHOR]

Significant cardiac morbidity and mortality exists in patients with COPD. Shared risk factors include age, smoking history and exposure to air pollution and passive smoke. Although the inappropriate under-prescribing of b-blockers contributes, it is now appreciated that the observed cardiac risk is not only due to smoking and conventional cardiovascular risk factors, but also other independent factors. A number of hypotheses exist for the increased cardiovascular morbidity and mortality seen in COPD including inflammation, pulmonary hypertension, lung hyperinflation and shared genetics models. Mounting evidence from large randomised controlled trials suggests that COPD treatment may be cardio-protective. We review the current evidence supporting the aforementioned hypotheses and how their modulation may prevent cardiovascular morbidity and mortality in COPD. The persisting underdiagnosis of COPD may have significant consequences. Further mechanistic studies identifying the onset and impact of individual interventions will develop our understanding of this emerging and highly relevant clinical field. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic status (SES) is an important determinant of health and premature death. However, the impact of poor SES on the health status of patients with chronic obstructive pulmonary disease (COPD) has not been well determined. Objective: It was our aim to assess the impact of SES on the quality of life in COPD patients. Methods: This was a cross-sectional, observational, multicenter study. A total of 4,574 patients completed the EuroQol 5-dimension questionnaire (EQ-5D) and the Airways Questionnaire 20 (AQ20). SES was based on the subject's occupation and educational level. Occupational categories were based on the major group classification of the International Standard Classification of Occupations. Results: The mean age of the population was 67.1 years and the mean forced expiratory volume was 43.4%. There was a gradient of impairment in health-related quality of life (HRQoL) according to the educational level, with significantly worse scores for the EQ-5D and the AQ20 for medium and low educational levels compared with high education (p < 0.001). Similarly, HRQoL was also significantly impaired in more unskilled workers, with a gradient of the AQ20 from 8.6 units (SD 4.8) in class I to 10.1 units (4.6) in class V (p < 0.001) and from 0.75 units in class I to 0.63 units in class V for the EQ-5D index, as well as from 62.9 units in class I to 55.6 units in class V for the EQ-5D visual analogue scale (p < 0.001 for all comparisons). These differences remained significant after controlling for covariates. Conclusions: Patients with a lower educational level and belonging to the unskilled professional groups had a poorer HRQoL. This is evident even in a country where access to health care services is universal and free. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background The effects of workplace second-hand smoke (SHS) on lung function remain uncertain because of a lack of objective measures for SHS exposures. Objective To determine whether an exposureeresponse association exists between lung function and two different markers of SHS based on indoor fine particulate (PM2.5) and urinary cotinine levels in non-smoking catering workers. Design A cross-sectional study during a 1.5-year exemption of licensed catering premises from smokefree legislation. Participants 186 non-smoking catering workers aged 18–65 years in Hong Kong were recruited. A declared non-smoking status was accepted in workers with exhaled breath carbon monoxide levels <6 ppm and urinary cotinine levels <100 ng/ml. Main outcome measures Lung function measures of forced expiratory volume in 1s (FEV1 in litres), forced vital capacity (FVC in litres) and forced expiratory flow as 25–75% of FVC (FEF25–75 in l/s) were recorded. Results Indoor fine particulate (PM2.5) concentrations were 4.4 times as high in smoking premises (267.9 mg/m3) than in non-smoking premises (60.3 mg/m3) and were strongly associated with the probability of permitted smoking (R2=0.99). Smoking was the dominant source of particulates (R2=0.66). Compared with workers exposed to the lowest indoor PM2.5 stratum (<25 μg/m3), lung function was lower in the three higher PM2.5 strata (25–75–175, >175 μg/m3) with FEV1 -0.072 (95% CI -0.123 to -0.021), -.078 (95% CI –0.132 to –0.024), –0.101 (95% CI –0.187 to –0.014); FEF25–75 –0.368 (95% CI –0.660 to –0.077), –0.489 (95% CI –0.799 to –0.179), –0.597 (95% CI –0.943 to –0.251); and FEV1/FVC (%) –2.9 (95% CI –4.8 to –1.0), –3.2 (95% CI –5.1 to –1.4) and –4.4 (95% CI –7.4 to –1.3), respectively. Urinary cotinine was associated positively with indoor PM2.5 but negatively with lung function. Consistently lower values for lung function per unit increase of indoor PM2.5 were found. Conclusion Lung function is inversely associated with workplace SHS. Workplace exemptions and delays in implementing smoke-free policies and current moves to relax legislation are a major threat to the health of workers. [ABSTRACT FROM AUTHOR]

In the present paper we investigate the relationship of environmental tobacco smoke (ETS) exposure to laryngeal cancer. 209 patients who were diagnosed with laryngeal cancer from 2000 to 2009 at the University Hospital of Patras, Western Greece, were reviewed with regard to patient age, disease stage at presentation, tumor differentiation, tobacco product use, alcohol consumption, occupation, and ETS exposure in the working environment. Pearson Chi-square method was used to determine the effect of ETS exposure on cancer stage, TNM classification and tumor differentiation in the dichotomized population (exposed vs. not exposed) and in groups of low, medium and high ETS exposure. ETS exposure in the working environment was found to significantly affect overall disease stage and T stage ( p < 0.01) both in the dichotomic analysis and the group analysis. Minor significance was also noted for N stage ( p = 0.047) in the exposure group analysis. Our data suggest that occupational ETS exposure presents a contributing risk factor for laryngeal cancer that requires further research to determine its significance. [ABSTRACT FROM AUTHOR]

The article informs on a research that studies the correlation between secondhand tobacco smoke (SHS)experienced by flight attendants and the development of respiratory illness and cardiovascular diseases. It is mentioned that smoking was banned in the airlines after the late 1980s prior to which flight attendants were exposed to large amount of SHS. Also, flight attendants suffer from various respiratory diseases and nasal congestion and throat and eye irritation were common before 1980s.

Background. Exposure to indoor allergens is an established risk factor for poor asthma control. Current guidelines recommend removing pets from the home of patients with asthma. Objectives. This cross-sectional study was conducted to determine the prevalence of furry pet ownership in asthmatics compared to nonasthmatics and to identify factors associated with furry pet ownership among those with asthma. Secondary analysis assessed characteristics among asthmatics that might be associated with allowing a furry pet into the bedroom. Methods. Using data from The National Asthma Survey collected from 2003 to 2004, we carried out univariate and multiple regression analyses, in 2009, to identify independent predictors of furry pet ownership in asthma sufferers after controlling for potential confounders. Results. Overall, asthmatics were more likely to own a furry pet than nonasthmatic individuals in the general population (49.9% versus 44.8%, p < .001). Multivariate analysis showed that female sex, older age, white race, and high income were independent predictors of furry pet ownership among asthmatics. Additionally, 68.7% of patients with asthma who own a furry pet allowed them into their bedroom. Higher income and carrying out ≤2 environmental control practices in the home were associated with increased likelihood of allowing a furry pet into the bedroom. Conclusions. Furry pet ownership is equally or more common among asthmatics compared to those without asthma. The majority of asthmatics with furry pets allow them into the bedroom. Recognizing and addressing these problems may help decrease asthma morbidity. [ABSTRACT FROM AUTHOR]

Objective. Minority children with asthma suffer a disproportionate burden of asthma morbidity. National asthma guidelines recommend use of environmental control practices (ECPs) as part of a comprehensive approach to asthma management. The purpose of this study was to examine use of ECPs among minority and nonminority children with asthma. Methods. The authors used data from the four state sample of the National Asthma Survey, a telephone survey conducted in 2003. The sample included Alabama, California, Illinois, and Texas. Parents provided responses for 2003 children ≤17 years of age with a diagnosis of asthma. The outcomes of interest were use of mattress covers, use of pillow covers, smoke avoidance, pet avoidance, and carpet removal. Univariate and multiple regression analyses were conducted to examine the rates of use of these ECPs among minority and nonminority children. Results. Black and Hispanic children with asthma were less likely to use mattress covers and pillow covers compared to white children in these four states. Smoking avoidance was less likely among black children but more likely among Hispanic children compared to white children. Both black and Hispanic children were more likely to live in a home without pets and without carpets compared to white children. Conclusions. These data illustrate that there are differences in the patterns of ECP use among minority and nonminority children with asthma in these four states. This information can help target physician counseling regarding ECP use in asthmatic children and should inform interventions to improve asthma management among minority children. [ABSTRACT FROM AUTHOR]

Background: The effects of the enforcement of a smoke-free workplace policy on health-related quality of life (HRQOL) among a healthy population are poorly understood. The present study was undertaken to examine the effects of the enforcement of a smoke-free school policy on HRQOL among healthy non-smoking schoolteachers with respect to their exposure to passive smoke. Methods: Two self-reported questionnaire surveys were conducted, the first before and the second after the enforcement of a total smoke-free public school policy in Nara City. A total of 1534 teachers were invited from 62 schools, and their HRQOL was assessed using six domains extracted from the Medical Outcomes Survey Short Form-8 questionnaire (SF-8): general health perception (GH), role functioning-physical (RP), vitality (VT), social functioning (SF), mental health (MH), and role functioning-emotional (RE). The participants were divided into two groups according to their exposure to environmental tobacco smoke (ETS) at baseline: participants not exposed to ETS at school (nonsmokers), and participants exposed to ETS at school (passive smokers). Changes in each SF-8 score were evaluated using paired t-tests for each group, and their inter-group differences were evaluated using multiple linear regression analyses adjusted for sex, age, school type, managerial position, and attitude towards a smoke-free policy. Results: After ineligible subjects were excluded, 689 teachers were included in the analyses. The number of nonsmokers and passive smokers was 447 and 242, respectively. Significant changes in SF-8 scores were observed for MH (0.9; 95% confidence interval [CI], 0.2-1.5) and RE (0.7; 95% CI, 0.0-1.3) in non-smokers, and GH (2.2; 95% CI, 1.2-3.1), VT (1.8; 95% CI, 0.9-2.7), SF (2.7; 95% CI, 1.6-3.8), MH (2.0; 95% CI, 1.0-2.9), and RE (2.0; 95% CI, 1.2-2.8) in passive smokers. In the multiple linear regression analyses, the net changes in the category scores of GH (1.8; 95% CI, 0.7-2.9), VT (1.4, 95% CI, 0.3-2.5), SF (2.5; 95% CI, 1.1-3.9), MH (1.2; 95% CI, 0.1-2.4) and RE (1.6; 95% CI, 0.5-2.7) in passive smokers significantly exceeded those in non-smokers. Conclusions: A smoke-free school policy would improve the HRQOL of healthy non-smoking teachers who are exposed to ETS. [ABSTRACT FROM AUTHOR]

Aims and objectives. Secondary analysis was conducted to interpret the causes of illness stories told by patients living with chronic obstructive pulmonary disease. Background. Despite the abundance of quantitative evidence regarding the causal relationship between smoking and chronic obstructive pulmonary disease, there is limited research that provides a contextual emic understanding of chronic obstructive pulmonary disease aetiology. Design. Interview data from two earlier focused ethnography studies were examined by retrospective interpretation, a type of secondary qualitative research. Chronic obstructive pulmonary disease causation stories were identified in both primary study data bases, but were not previously systematically examined. Methods. The analysis was completed using an eclectic, explicit narrative approach that involved the examination of causation story elements. Results. Participants told 104 causal stories about the development of their lung disease. They situated the aetiology of their chronic illness within a psychosocial reality. Conclusions. The causal stories told by participants demonstrate that those living with chronic obstructive pulmonary disease present a broader causal explanation for their illness, an orientation not commonly presented in the literature. They demonstrate the need for further examination of the important lay accounts of causes of illness in relation to chronic obstructive pulmonary disease. Relevance to clinical practice. Clinicians’ ability to hear an alternative understanding may be impeded when they only listen for what they already know, ‘facts’ concerning the relationship between smoking and chronic obstructive pulmonary disease. Addressing vulnerable persons in such a manner may impede patients’ efforts to be responsible for the development of their chronic illness and individualised care. [ABSTRACT FROM AUTHOR]

Background: A smoke-free law came into effect in Spain on 1st January 2006, affecting all enclosed workplaces except hospitality venues, whose proprietors can choose among totally a smoke-free policy, a partial restriction with designated smoking areas, or no restriction on smoking on the premises. We aimed to evaluate the impact of the law among hospitality workers by assessing second-hand smoke (SHS) exposure and the frequency of respiratory symptoms before and one year after the ban. Methods and Finding: We formed a baseline cohort of 431 hospitality workers in Spain and 45 workers in Portugal and Andorra. Of them, 318 (66.8%) were successfully followed up 12 months after the ban, and 137 nonsmokers were included in this analysis. We obtained self-reported exposure to SHS and the presence of respiratory symptoms, and collected saliva samples for cotinine measurement. Salivary cotinine decreased by 55.6% after the ban among nonsmoker workers in venues where smoking was totally prohibited (from median of 1.6 ng/ml before to 0.5 ng/ml, p<0.01). Cotinine concentration decreased by 27.6% (p = 0.068) among workers in venues with designated smoking areas, and by 10.7% (p = 0.475) among workers in venues where smoking was allowed. In Portugal and Andorra, no differences between cotinine concentration were found before (1.2 ng/ml) and after the ban (1.2 ng/ml). In Spain, reported respiratory symptom declined significantly (by 71.9%; p<0.05) among workers in venues that became smoke-free. After adjustment for potential confounders, salivary cotinine and respiratory symptoms decreased significantly among workers in Spanish hospitality venues where smoking was totally banned. Conclusions: Among nonsmoker hospitality workers in bars and restaurants where smoking was allowed, exposure to SHS after the ban remained similar to pre-law levels. The partial restrictions on smoking in Spanish hospitality venues do not sufficiently protect hospitality workers against SHS or its consequences for respiratory health. [ABSTRACT FROM AUTHOR]

The article provides a register-based population study to determine the incidence rates of asthma among woodworkers, blue-collar workers, and administrative personnel in wood-processing industries in Finland. Age-adjusted incidence rates and relative risks (RR) by gender were estimated for the workers of wood-processing industries. It is concluded that there is a high-incidence rate of asthma both among the woodworkers and the other blue-collar workers in the wood-processing industries.

The article presents medical research into secondhand smoke exposure and health-related quality of life in men and women who have never smoked. Study subjects were participants of the Swiss Cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA) in Switzerland. Sources of secondhand smoke were the workplace, public spaces, and the home. Eight domains of the Short Form Health Survey (SF-36) include general health, mental health, role emotional, role physical, vitality, and social functioning.

Objectives. We studied the impact of clean indoor air law exemptions and preemption policies on the prevalence of a tobacco-specific lung carcinogen — 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) — among nonsmoking bar and restaurant workers. Methods. We collected urine specimens from 32 nonsmoking bar and restaurant workers from communities in Oregon where smoking is prohibited in bars and restaurants, and from 52 participants from communities in Oregon where smoking is allowed. Urine specimens collected before and after a workshift were analyzed for 3 NNK metabolites and reported as total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL). Urinalysis results from participants protected from workplace secondhand smoke were compared with results from participants who were exposed to it. Results. Participants exposed to workplace secondhand smoke were more likely to have any detectable level of NNAL (P=.005) and higher mean levels of NNAL (P<.001) compared with nonexposed participants. Increased levels of NNAL were also associated with hours of a single workplace exposure (P=.005). Conclusions. Nonsmoking employees left unprotected from workplace secondhand smoke exposure had elevated levels of a tobacco-specific carcinogen in their bodies. All workers — including bar and restaurant workers — should be protected from indoor workplace exposure to cancer-causing secondhand smoke. (Am J Public Health. 2007;97:1457-1463. doi:10.2105/AJPH.2006.094086) [ABSTRACT FROM AUTHOR]

The article focuses on the pathobiology of cigarette smoke-induced Chronic Obstructive Pulmonary Disease (COPD). It provides an analysis on the molecular and cellular pathobiology of COPD based on human and/or animal data. It discusses the risk factors of chronic obstructive pulmonary disease as well as the mediators and signaling pathways that link to inflammation, protease/antiproteases, oxidative stress and apoptosis.

Presents a study which examined tobacco use among adult asthma patients in California. Methods; Results; Discussion.

The author discusses the health effects in non-smoking workers of occupational second hand smoke (SHS) exposure in hospitality venues and the effects of non-smoking regulations. SHS has been pointed out as an important public health threat with many adverse health effects. It has been linked with increased risk of adverse cardiovascular health outcome, lung cancer, different respiratory symptoms and deterioration in pulmonary function.

OBJECTIVE: To examine attitudinal changes of bar owners and staff regarding a smoke-free bar law. DESIGN: Bar owners and staff were random selected and telephone interviewed in June 1998, shortly after a smoke-free bar law was enacted, and October 2002. Similar instruments were used in both surveys to collect data on attitudes related to secondhand smoke (SHS) and behaviours related to the smoke-free bar law. PARTICIPANTS: 651 and 650 respondents worked for either stand alone bars or combination bars. MEASURES: Preference of working in a smoke-free environment, concerns of the effect of SHS, and how to comply with the law. RESULTS: The percentage of bar owners or staff working in stand alone bars who prefer to work in a smoke-free environment increased from 17.3% in 1998 to 50.9% in 2002 (p < 0.001). Significantly more respondents (45.5%) working in stand alone bars were concerned about the effects of SHS on their health, comparing to 21.6% in 1998 (p < 0.001). When patrons smoked in the bar, 82.1% of stand alone bar owners or staff in the 2002 survey would ask them to stop or to smoke outside, increased from only 43.0% in the 1998 survey (p < 0.001). CONCLUSION: A positive and significant attitudinal change related to the smoke-free bar law occurred among California bars. [ABSTRACT FROM AUTHOR]

The article presents a response by Daniel Menzies and Brian Lipworth to a letter to the editor about the article "Respiratory symptoms, pulmonary function and markers of inflammation among bar workers before and after a legislative ban on smoking in public places," in a previous issue.

The article reports on the research findings on combination treatment of patients with chronic obstructive pulmonary disease (COPD). It is stated that although the salmeterol-fluticasone combination failed to demonstrate an improvement in mortality according to the predefined statistical criteria, it did show significant improvement in exacerbation rates, health status and lung function.

The article presents a letter to the editor in response to the article "Respiratory symptoms, pulmonary function and markers of inflammation among bar workers before and after a legislative ban on smoking in public places," by D. Menzies, A. Nair, and P. A. Williamson in a previous issue.