Exposición laboral y a biomasa en la enfermedad pulmonar obstructiva crónica: resultados de un análisis transversal del estudio On-Sint

Lόpez-Campos, José Luís; Fernández-Villar, Alberto; Calero-Acuña, Carmen; Represas-Represas, Cristina; López-Ramírez, Cecilia; Leiro-Fernández, Virginia; Casamor, Ricard

doi:10.1016/j.arbres.2016.04.013

Cited by 14 publications

(7 citation statements)

References 27 publications

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“…Much less biomass fuel is used in developed countries such as Spain. 26 However, the frequency of biomass smoke exposure was high in our study. Available epidemiological studies demonstrate that biomass smoke is an important cause of COPD.…”

Section: Discussioncontrasting

confidence: 66%

“…One survey reported that COPD caused by tobacco plus other inhalants led to greater impairment of quality of life. 26 Our work demonstrated that patients exposed to tobacco plus other risk factors had worse respiratory symptoms and more frequent exacerbations than those who were exposed to tobacco alone. This finding suggests that combined exposure to tobacco plus other risk factors has a noxious additive effect in COPD patients and could result in more serious COPD symptoms.…”

Section: Discussionmentioning

confidence: 59%

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<p>Characteristics of Patients with Chronic Obstructive Pulmonary Disease Exposed to Different Environmental Risk Factors: A Large Cross-Sectional Study</p>

Duan¹,

Cheng²,

Zeng³

et al. 2020

COPD

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Purpose: Tobacco smoking, biomass smoke, and occupational exposure are the main risk factors for chronic obstructive pulmonary disease (COPD). The present study analyzes data on exposure to these factors in a cohort of patients with COPD and assesses their differences in demographic and clinical characteristics. Patients and Methods: The cross-sectional observational study was conducted from November 2016 to December 2019. Inclusion criteria were patients aged over 40 years old with post-bronchodilator forced expiratory volume in 1 second (FEV 1)/forced vital capacity (FVC) <0.7. At baseline, demographic features and exposure history were recorded. Moreover, respiratory symptoms were assessed by the COPD Assessment Test (CAT) and modified Medical Research Council scale (mMRC). A generalized linear mixed model was used to adjust for potential confounders. Results: A total of 5183 patients with COPD were included in the final analysis. The results demonstrate that exposure to tobacco combined with other risk factors resulted in significantly higher CAT scores (16.0 ± 6.7 vs 15.3 ± 6.3, P = 0.003) and more severe dyspnea (patients with mMRC ≥ 2, 71.5% vs 61.6%, P < 0.001) than exposure to tobacco alone. In addition, COPD patients with biomass smoke exposure alone had higher CAT scores than patients with only tobacco or occupational exposure (17.5 ± 6.3 vs 15.3 ± 6.3, and 15.2 ± 6.3, respectively, P < 0.05 for each comparison) and were more likely to be female and older. In addition, COPD patients who suffered from occupational exposure developed more severe dyspnea than those exposed to tobacco alone (70.8% vs 61.6%, P < 0.05), as did those exposed to biomass smoke alone (74.2% vs 61.6%, P < 0.05). This difference remained strong even after adjustment for potential confounders. Conclusion: There are significant demographic and clinical differences among COPD patients with tobacco smoking, biomass smoke, and occupational exposures.

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 59%

<p>Characteristics of Patients with Chronic Obstructive Pulmonary Disease Exposed to Different Environmental Risk Factors: A Large Cross-Sectional Study</p>

Duan¹,

Cheng²,

Zeng³

et al. 2020

COPD

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“…Occupational exposure is associated with around 15% of total COPD; however, this has been poorly studied in Central and South America [57, 68, 69]. A study of pig farmers in Brazil showed a prevalence of chronic bronchitis of 5.1% in workers aged more than 40 years [70].…”

Section: Central and South Americamentioning

confidence: 99%

Under- and over-diagnosis of COPD: a global perspective

Cusack

Chaudhary

et al. 2019

Breathe

141

100

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Globally, chronic obstructive pulmonary disease (COPD) is the fourth major cause of mortality and morbidity and projected to rise to third within a decade as our efforts to prevent, identify, diagnose and treat patients at a global population level have been insufficient. The European Respiratory Society and American Thoracic Society, along with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy document, have highlighted key pathological risk factors and suggested clinical treatment strategies in order to reduce the mortality and morbidity associated with COPD. This review focuses solely on issues related to the under- and over-diagnosis of COPD across the main geographical regions of the world and highlights some of the associated risk factors. Prevalence of COPD obtained mainly from epidemiological studies varies greatly depending on the clinical and spirometric criteria used to diagnose COPD,i.e.forced expiratory volume in 1 s to forced vital capacity ratio <0.7 or 5% below the lower limit of normal, and this subsequently affects the rates of under- and over-diagnosis. Although under-utilisation of spirometry is the major reason, additional factors such as exposure to airborne pollutants, educational level, age of patients and language barriers have been widely identified as other potential risk factors. Co-existent diseases, such as asthma, bronchiectasis, heart failure and previously treated tuberculosis, are reported to be the other determinants of under- and over-diagnosis of COPD.Key pointsGlobally, there is large variation in the prevalence of COPD, with 10–95% under-diagnosis and 5–60% over-diagnosis (table 1) due to differences in the definition of diagnosis used, and the unavailability of spirometry in rural areas of low- and middle-income countries where the prevalence of COPD is likely to be high.In order to be diagnosed with COPD, patients must have a combination of symptoms with irreversible airflow obstruction defined by a post-bronchodilator FEV1/FVC ratio of <0.7 or below the fifth centile of the lower limit of normal (LLN), and with a history of significant exposure to a risk factor. Repeat spirometry is recommended if the ratio is between 0.6 and 0.8.Not performing spirometry is the strongest predictor for an incorrect diagnosis of COPD; however, additional factors, such as age, gender, ethnicity, self-perception of symptoms, co-existent asthma, and educational awareness of risk factor by patients and their physician, are also important.COPD can be associated with inhalation of noxious particles other than smoking tobacco.Educational aimsTo summarise the global prevalence of over- and under-diagnosis of COPD.To highlight the risk factors associated with the under- and over-diagnosis of COPD.To update readers on the key changes in the recent progress made regarding the correct diagnosis of COPD.

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“…However, biomass smoke exposure is also a concern in industrialized countries. 2 – 4 B-COPD has some differences compared to COPD caused by tobacco (T-COPD). Patients with B-COPD have a slower decline of forced expiratory volume in 1 s (FEV 1 ) and a different distribution of phenotypes.…”

Section: Introductionmentioning

confidence: 99%

Differences in systemic inflammation between cigarette and biomass smoke-induced COPD

Golpe

Martín-Robles

Sanjuán-López

et al. 2017

COPD

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Background and objectiveIt is known that biomarkers of systemic inflammation are raised in COPD caused by tobacco (T-COPD) compared with healthy controls, but there is less information on the inflammatory status of subjects with COPD caused by biomass smoke (B-COPD). In addition, the possible (if any) differences in inflammation between both types of the disease are still not well known. The aim of this study was to assess the inflammatory profile in B-COPD and T-COPD.MethodsA total of 20 subjects (15 men and five women) with T-COPD were matched one to one for sex, age and forced expiratory volume in 1 s (FEV1) to 20 B-COPD patients. In all, 20 sex-matched healthy subjects with normal lung function without smoking history or biomass exposure were included as controls. The following biomarkers were measured: exhaled nitric oxide, serum IL-6, IL-8, IL-5, IL-13, periostin, surfactant protein-P, TNF-α, IgE, erythrocyte sedimentation rate, C-reactive protein and fibrinogen. Complete blood count was also obtained.ResultsThe age of the subjects was 70.2±7.9 years and FEV1% was 56.2%±14.6%. Most inflammatory biomarkers were higher in both types of COPD than in healthy controls. IL-6, IL-8 and IL-5 were significantly higher in T-COPD than in B-COPD, without other significant differences.ConclusionBoth types of COPD are associated with high levels of systemic inflammation biomarkers. T-COPD patients have a higher systemic inflammatory status than the patients with B-COPD.

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Exposición laboral y a biomasa en la enfermedad pulmonar obstructiva crónica: resultados de un análisis transversal del estudio On-Sint

Cited by 14 publications

References 27 publications

<p>Characteristics of Patients with Chronic Obstructive Pulmonary Disease Exposed to Different Environmental Risk Factors: A Large Cross-Sectional Study</p>

<p>Characteristics of Patients with Chronic Obstructive Pulmonary Disease Exposed to Different Environmental Risk Factors: A Large Cross-Sectional Study</p>

Under- and over-diagnosis of COPD: a global perspective

Differences in systemic inflammation between cigarette and biomass smoke-induced COPD

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