Estimating the U.S. prevalence of chronic obstructive pulmonary disease using pre- and post-bronchodilator spirometry: the National Health and Nutrition Examination Survey (NHANES) 2007–2010

BACKGROUND: During 2007–2010, the National Health and Nutrition Examination Survey (NHANES) conducted a spirometry component which obtained pre-bronchodilator pulmonary lung function data on a nationally representative sample of US adults aged 6–79 years and post-bronchodilator pulmonary lung function data for the subset of adults with airflow limitation. The goals of this study were to 1) compute prevalence estimates of chronic obstructive pulmonary disease (COPD) using pre-bronchodilator and post-bronchodilator spirometry measurements and fixed ratio and lower limit of normal (LLN) diagnostic criteria and 2) examine the potential impact of nonresponse on the estimates. METHODS: This analysis was limited to those aged 40–79 years who were eligible for NHANES pre-bronchodilator spirometry (n=7,104). Examinees with likely airflow limitation were further eligible for post-bronchodilator testing (n=1,110). Persons were classified as having COPD based on FEV(1)/FVC < 70% (fixed ratio) or FEV(1)/FVC < lower limit of normal (LLN) based on person’s age, sex, height, and race/ethnicity. Those without spirometry but self-reporting both daytime supplemental oxygen therapy plus emphysema and/or current chronic bronchitis were also classified as having COPD. The final analytic samples for pre-bronchodilator and post-bronchodilator analyses were 77.1% (n=5,477) and 50.8% (n=564) of those eligible, respectively. To account for non-response, NHANES examination weights were adjusted to the eligible pre-bronchodilator and post-bronchodilator subpopulations. RESULTS: In 2007–2010, using the fixed ratio criterion and pre-bronchodilator test results, COPD prevalence was 20.9% (SE 1.1) among US adults aged 40–79 years. Applying the same criterion to post-bronchodilator test results, prevalence was 14.0% (SE 1.0). Using the LLN criterion and pre-bronchodilator test results, the COPD prevalence was 15.4% (SE 0.8), while applying the same criterion to post-bronchodilator test results, prevalence was 10.2% (SE 0.8). CONCLUSIONS: The overall COPD prevalence among US adults aged 40–79 years varied from 10.2% to 20.9% based on whether pre- or post-bronchodilator values were used and which diagnostic criterion (fixed ratio or LLN) was applied. The overall prevalence decreased by approximately 33% when airflow limitation was based on post-bronchodilator as compared to pre-bronchodilator spirometry, regardless of which diagnostic criterion was used

Long-Term Exposure to Silica Dust and Risk of Total and Cause-Specific Mortality in Chinese Workers: A Cohort Study

A retro-prospective cohort study by Weihong Chen and colleagues provides new estimates for the risk of total and cause-specific mortality due to long-term silica dust exposure among Chinese workers

Combined effect of dust exposure and tobacco smoking on the occorence of lung disease in South African gold miners

A Thesis submitted to the Faculty of Medicine University of the Witwatersrand, Johannesburg for the Degree of Doctor of Philosophy April 1991 JohannesburgThe objective of this thesis is to investigate whether tobacco smoking modifies the effect of gold mining dust exposure on the occurrence of lung diseases known, or suspected, to be causally associated with the gold mining occupation. In particular, the purpose is to ascertain whether the combined effect of dust and smoking on these diseases' occurrences is additive (i.e. the effects are independent), or synergistic (i.e. smoking increases the effect of dust), or antagonistic (i.e. smoking decreases the effect of dust).IT201

Twice as good as others (and still discriminated) : Successful Romani Women representation in the Czech and Slovak media

Stigmatisation of Romani women is the rule rather than the exception in many countries around Europe, something that has also been confirmed through research. That is one reason why I have chosen to highlight successful Romani women in this study. More specifically, this essay investigates how successful Romani women are represented in the media in the Czech Republic and Slovakia. Through a thematic analysis, I have identified three major themes that I analyse with support of previous research as well as an intersectional perspective. The three themes are that: 1) Romani women achieved a lot, but it was “not enough”, 2) The women embraced their ethnicity, but a negative discourse of the media to Roma was projected through the approach of some reporters, 3) The women aimed to “change the world”. The overall picture was fairly homogenous yet interesting; everyone appeared to be of a heterosexual orientation, family and education were emphasised as tools to succeed in the labour market and discrimination was shown as an unequivocal barrier to their success

Effect of Occupational Exposures on Decline of Lung Function in Early Chronic Obstructive Pulmonary Disease

Rationale: Several occupational exposures adversely affect lung function