Objectives-A cross sectional study of respiratory symptoms and lung function in welders was performed at eight New Zealand welding sites: 62 current welders and 75 non-welders participated. Methods-A questionnaire was administered to record demographic data, smoking habit, and current respiratory symptoms. Current and previous welding exposures were recorded to calculate a total lifetime welding fume exposure index. Forced expiratory volume in one second (FEV 1 ), forced vital capacity (FVC), and peak expiratory flow (PEF) were measured before the start of the shift. Results-There were no significant diVerences in ethnicity, smoking habits, or years of work experience between welders and non-welders. Symptoms of chronic bronchitis were more common in current welders (11.3%) than in non-welders (5.0%). Of those workers with a cumulative exposure index to welding fume >10 years, 16.7% reported symptoms of chronic bronchitis compared with 4.7% of those with a cumulative exposure index <4 years (odds ratio (OR) 4.1, 95% confidence interval (95% CI) 0.90 to 17.6). Workers with chronic bronchitis had significantly lower measures of baseline PEF (p=0.008) and FEV 1 /FVC ratio (p=0.001) than workers without chronic bronchitis. Multivariate analysis showed that current smoking (OR 9.3, 1.0 to 86.9) and total exposure index to welding fumes >10 years (OR 9.5, 1.3 to 71.9) were independent risk factors for chronic bronchitis. The report of any work related respiratory symptom was more prevalent in welders (30.7%) than non-welders (15.0%) and workers with these symptoms had significantly lower FEV 1 (p=0.004) and FVC (p=0.04) values. Multivariate analysis identified a high proportion of time spent welding in confined spaces as the main risk factor for reporting these symptoms (OR 2.8, 1.0 to 8.3). Conclusion-This study has documented a high prevalence of symptoms of chronic bronchitis and other work related respiratory symptoms in current welders. Also, workers with chronic bronchitis had reduced PEF and FEV 1 /FVC compared with those without chronic bronchitis. These symptoms related both to cigarette smoking and a measure of lifetime exposure to welding fume. (Occup Environ Med 1998;55:150-154)
This study identified frequently reported musculoskeletal, skin and respiratory symptoms in hairdressers. This points to a need to develop training that not only deals with risk assessment but also informs hairdressers about the health risks of their work.
IntroductionThe impact of asthma and chronic obstructive pulmonary disease (COPD) on individuals’ lives may be substantial, yet clinical practice often focuses only on symptoms. We aimed to better understand the perspective of asthma or COPD patients and to identify condition-related burden, life impact, priorities, unmet needs, and treatment goals.MethodsIndividuals aged at least 18 years with asthma or COPD were identified by a recruitment panel via clinical referrals, support groups, consumer networks, and a patient database. Interviews were carried out individually (by telephone) or in focus groups (with no more than five participants per group). A semi-structured interview guide was used with prespecified topics, informed by a literature review, that were considered impactful in asthma or COPD (symptoms and daily-life impact, satisfaction with current treatment, important aspects of treatment, adherence, and ideal treatment).ResultsOverall, 72 people participated in focus groups/individual interviews (asthma n = 18/n = 21; COPD n = 15/n = 18). “Shortness of breath” was the most frequently reported symptom; however, participants discussed the life impact of their condition more than symptoms alone. Reported physical impacts included the inability to sleep and socialize, while emotional impacts included “embarrassment, stigma, and/or self-consciousness”, “fear and/or panic”, and “sadness, anxiety, and/or depression”. Coping mechanisms for normal activities included continuing at reduced pace and avoidance. Treatment preferences centered on resolving impacts; improved sleep, “speed of action”, and “length of relief” were the most frequently reported ideal treatment factors.ConclusionPatients with asthma or COPD experience substantial quality of life limitations and tend to focus on these in their expressions of concern, rather than symptoms per se. Life impacts of these conditions may have implications beyond those commonly appreciated in routine practice; these considerations will be applied to a future discrete choice experiment survey.FundingGSK funded study (H0-15-15502/204821).Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-017-0557-0) contains supplementary material, which is available to authorized users.
The objectives of this study were to measure the population prevalence of symptoms of chronic obstructive lung disease and mild airway obstruction and to compare these between occupational groups. There were 1,609 subjects (63.9% response rate) who completed a respiratory questionnaire. Of these, 1,132 (70.4%) underwent pulmonary function testing (FEV1 and FVC). Twenty-one categories of current occupation were used for analysis. Four definitions of chronic obstructive pulmonary disease (COPD) were used: (1) chronic bronchitis, (2) chronic bronchitis with airway obstruction, (3) shortness of breath, and (4) shortness of breath with airway obstruction. For chronic bronchitis, adjusted prevalence odds ratios were significantly elevated for food processors other than bakers (OR = 2.83; 95% CI, 1.27 to 6.29) and chemical processors (OR = 18.84; 3.71 to 95.64). The combination of chronic bronchitis and mild airway obstruction (FEV1/FVC < 0.75) was associated with bakers (OR = 25.5; 3.86 to 168.53) and spray painters (OR = 14.40; 2.85-72.69). Shortness of breath was associated with hairdressers (OR = 2.75; 0.80 to 9.42) and bakers (OR = 6.72; 0.57 to 79.66), and nursing was associated with lower levels of shortness of breath (OR = 0.42; 0.16 to 1.15). Working ever with vapors, gases, dust, or fumes was significantly associated with chronic bronchitis and airway obstruction (OR = 3.13; 1.07 to 9.12). This population-based study has identified certain occupations with increased prevalence of chronic bronchitis and COPD.
Aims To examine the prevalence of symptoms of asthma and allergy in different farming groups in New Zealand. Methods A postal questionnaire was sent to a random sample of 2,500 farmers throughout New Zealand. Results The response rate was 77% (1,706 of 2,203 eligibles). The 12‐month period prevalence of current asthma was 11.8% overall, compared with 15% in the general population. Asthma prevalence was higher for horse breeders/groomers (16.5%), pig farmers (18.2%), poultry farmers (17.4%), and those working with oats (17.4%). Asthma was also significantly elevated among those working with cleaning powders (14.7%). Women were more likely to report current asthma than were men (OR 1.8, 95% CI 1.3–2.5). Hay fever was significantly higher in deer and crop farmers, and farmers working with horses and goats; eczema was higher for goat and deer farmers. Conclusions The lower overall prevalence of asthma in farmers may be due to the healthy worker effect. Among farmers, the types of farming associated with an elevated prevalence of asthma and allergy in New Zealand are deer and goat farming, working with horses, poultry, pigs, and crop farming. Females reported more current asthma than males. Am. J. Ind. Med. 35:51–57, 1999. © 1999 Wiley‐Liss, Inc.
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Objectives-To examine whether welding is a risk factor for an accelerated decline in pulmonary function. Methods-2 Year follow up of pulmonary function and respiratory symptoms among 54 welders and 38 non-welders in eight New Zealand welding sites. Results-There were no significant diVerences in age, height, smoking habits, ethnicity, or total time in industrial work between welders and non-welders. No overall diVerences were noted in the changes of pulmonary function variables between the two study groups. However, when the comparison was restricted to smokers, welders had a significantly greater (p=0.02) annual decline (88.8 ml) in FEV 1 than non-welders, who had a slight non-significant annual increase (34.2 ml). Also, welders without respiratory protection or local exhaust ventilation while welding had a greater annual decline both in forced vital capacity (FVC) and forced expiratory volume in one second (FEV 1 ) than welders with protection (p=0.001 and 0.04, respectively). Among welders a significant association was found between the acute across shift change and the annual decline in FEV 1 . Chronic bronchitis was more common among welders (24%) than non-welders (5%). Only one welder (2%) but eight nonwelders (21%) reported having asthma. Conclusions-Welders who smoked and welders working without local exhaust ventilation or respiratory protection have an increased risk of accelerated decline in FEV 1 . (Occup Environ Med 1999;56:328-333)
A random sample of managers of small and medium-sized enterprises (SMEs) was selected from a database of businesses in Sheffield, UK. They were invited to take part in a study to evaluate the provision and perception of occupational health in SMEs in Sheffield. The study used an interviewer-led questionnaire, which collected quantitative and qualitative data; each interview took approximately 40 min to complete. Several approaches to recruitment were adopted during the study. Twenty-eight managers were interviewed over the 6 month study period. All of the SMEs employed <250 people; 43.2% did not have or had never reviewed a written health and safety policy. Only 18% had a written occupational health policy; 14.4% employed the services of a part-time occupational health physician; 7.2% employed a health and safety advisor; and 10.8% employed a part-time occupational health nurse. Twenty-five per cent had a nominated person responsible for occupational health and 67% thought that a doctor or nurse would be the best person to provide an occupational health service. Twenty-eight per cent of the companies carried out some form of pre-employment screening and 14.2% carried out health promotion. Fifteen (53.5%) collected some form of health related absence data. Eight companies (28.6%) organized a formal induction programme for all new employees. Further work should be undertaken in an attempt to improve access to local industry and particularly to SMEs. This study has clearly shown that access is possible, but different strategies of approach were required before a workable strategy could be found. Undoubtedly, this access can be improved by better understanding of the interaction between researchers, occupational health providers and local managers of SMEs.
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