10 research outputs found
Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study
Background
Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study.
Methods
We analysed cross-sectional data from 28â823 adults (â„40â
years) in 34 countries. We considered 11 occupations and grouped them by likelihood of exposure to organic dusts, inorganic dusts and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, forced vital capacity (FVC) and forced expiratory volume in 1â
s (FEV1)/FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income.
Results
Overall, working in settings with potentially high exposure to dusts or fumes was associated with respiratory symptoms but not lung function differences. The most common occupation was farming. Compared to people not working in any of the 11 considered occupations, those who were farmers for â„20â
years were more likely to have chronic cough (OR 1.52, 95% CI 1.19â1.94), wheeze (OR 1.37, 95% CI 1.16â1.63) and dyspnoea (OR 1.83, 95% CI 1.53â2.20), but not lower FVC (ÎČ=0.02â
L, 95% CI â0.02â0.06â
L) or lower FEV1/FVC (ÎČ=0.04%, 95% CI â0.49â0.58%). Some findings differed by sex and gross national income.
Conclusion
At a population level, the occupational exposures considered in this study do not appear to be major determinants of differences in lung function, although they are associated with more respiratory symptoms. Because not all work settings were included in this study, respiratory surveillance should still be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.publishedVersio
A framework for image-guided breast surgery
Breast-conserving surgery for the treatment of cancer frequently requires a repeat operation due to the initial excision of the tumour being incomplete. Improved image guidance, using preoperative MR images, might help to reduce this high re-excision rate. Since the diagnostic MR images are acquired prone, but surgery is performed supine, significant deformation of the soft tissue of the breast occurs. We have developed an approach to account for this deformation based on a patient-specific biomechanical model. The model is constructed from a supine MR image, and it is used to initialize a non-rigid intensity-based registration of the diagnostic prone MR image with the supine image. In the operating theatre the surface of the breast is acquired with a stereo camera, and the model is deformed to match this surface in order to predict the position of the lesion. We illustrate our framework with initial results for one patient case, in which we estimate our target registration error to be 4mm