<p>Lifetime Occupational History, Respiratory Symptoms and Chronic Obstructive Pulmonary Disease: Results from a Population-Based Study</p>

Abstract

Purpose: To ascertain the effect of lifelong occupational history, ambient air pollution, and biochemically verified smoking status on chronic obstructive pulmonary disease (COPD) in a general population of one the largest cities in Central Asia, Almaty. Patients and methods: 1500 adults (median age 49, interquartile range (IQR) 28 years), 50% females, were randomly selected from a registry of enlisted population of a primary care facility in Almaty, Kazakhstan and they filled in the questionnaire on demographics, respiratory symptoms (CAT and mMRC), smoking status, verified by exhaled carbon monoxide, and detailed lifetime occupational history. COPD was defined as postbronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) below lower limit of normal (LLN) using Belintelmed MAS-2 spirometer (Belarus). Results: 230 (15%) subjects had CAT≥10; 136 (9%) participants had mMRC score ≥2. Greater CAT score was associated with age, smaller income, and less exercise, but not with smoking or living closer to a major road. 26% of the population was ever exposed to vapors, gases, dusts, and fumes (VGDF). In age group 40 years and above (N=1024), COPD was found in 57 participants (prevalence 5.6%), more in men (8.7% vs 3.4%). In the multivariate model adjusted for age, sex, ever-smoking, income, and exercise, any exposure to VGDF increased the odds of COPD (odds ratio (OR) 1.71; 95% confidence interval (CI) 1.03; 2.84), more in the highest exposure category (OR 2.36 (95% CI 1.20; 4.66)). Conclusion: Lifetime exposure to VGDF, found in ¼ of the general population, increased the odds of COPD independent of smoking by 71%.

Occupational Burden of Chronic Obstructive Pulmonary Disease in the Commonwealth of Independent States: Systematic Review and Meta-Analysis

“…In a meta-proportion analysis, heterogeneity between studies was very high ( I 2 = 99%, p < 0.001); therefore, we applied the random effects model for this test. The pooled PAF% for three included studies [Andreeva et al ( 8 ), 1.78%; Bilbov et al ( 10 ), 4.99%; and Vinnikov et al ( 11 ), 15.6%] was 6% (95% CI 2;14). The source of such heterogeneity was the study of Vinnikov et al from Kazakhstan, in which PAF% was significantly different from the Russian studies, because it was a specially designed study with a detailed occupational history analysis.…”

“…Twelve studies were selected for full-text extraction from www.elibrary.ru along with 12 studies to be downloaded as full-text articles to screen eligibility for inclusion from PubMed. Eligibility screening of the full texts of articles from PubMed allowed us to narrow the number of eligible studies to five, which were published between 2014 and 2019 ( 7 – 11 ). The study of Nugmanova et al was conducted in three countries, including Azerbaijan, Kazakhstan, and Ukraine; therefore, data from Azerbaijan and Kazakhstan could be analyzed in the current presentation and were extracted separately.…”

“…Alternatively, in the recent study of Vinnikov et al ( 11 ), also conducted in Almaty, lifetime occupational history was collected. Moreover, COPD was confirmed in subjects having postbronchodilator FEV 1 /FVC < LLN, and the association was tested in multivariate regression models adjusted for age, sex, smoking, income, and exercise.…”

“…Given that standardized questionnaires were applied in these studies, low fraction of population with exposure to VGDF can then be explained by the skewness toward less exposed population in the sample. The contract is obvious when comparing studies specifically designed to ascertain the burden of occupational exposures ( 11 ) with those where risk factors for COPD were multiple and occupational hazards were not the risks of primary interest ( 8 , 10 ). Taken together, all that highlights the need for better occupational history collection in the future population-based studies in these countries.…”

Gastos com DPOC e câncer de pulmão, brônquios e traqueia para o SUS relacionados à Cidade de Altamira (PA) entre os anos de 2017 e 2020

“…A saúde de trabalhador também deve ser prioridade para o governo, tendo em vista que é determinante para o combate às patologias respiratórias abordadas neste estudo, pois a exposição ocupacional é fator evitável ou no mínimo capaz de ser mitigado. Assim, ocupações perigosas para a integridade pulmonar, como mineração, exploração de madeira e garimpagem, exigem carga de trabalho reduzida e atenuação na medida do possível da exposição às substâncias tóxicas para a saúde pulmonar humana, para prevenir tanto a DPOC quanto o câncer de pulmão, traqueia e brônquios (Gelati et al, 2017;Vinnikov et al, 2019). É válido ressaltar a importância de empregadores oferecerem Equipamentos de Proteção Individual (EPIs) e capacitação para a utilização adequada desses, porquanto, caso seu uso seja inadequado, tais itens apenas contribuirão para o desconforto do usuário e o para o perigo de exposição a agentes maléficos à respiração (Bagatin & Kitamura, 2006).…”