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 28 823 adults (≥40 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 1 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 ≥20 years were more likely to have chronic cough (OR 1.52, 95% CI 1.19–1.94), wheeze (OR 1.37, 95% CI 1.16–1.63) and dyspnoea (OR 1.83, 95% CI 1.53–2.20), but not lower FVC (β=0.02 L, 95% CI −0.02–0.06 L) or lower FEV1/FVC (β=0.04%, 95% CI −0.49–0.58%). 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

Cohort Profile: Burden of Obstructive Lung Disease (BOLD) study

The Burden of Obstructive Lung Disease (BOLD) study was established to assess the prevalence of chronic airflow obstruction, a key characteristic of chronic obstructive pulmonary disease, and its risk factors in adults (≥40 years) from general populations across the world. The baseline study was conducted between 2003 and 2016, in 41 sites across Africa, Asia, Europe, North America, the Caribbean and Oceania, and collected high-quality pre- and post-bronchodilator spirometry from 28 828 participants. The follow-up study was conducted between 2019 and 2021, in 18 sites across Africa, Asia, Europe and the Caribbean. At baseline, there were in these sites 12 502 participants with high-quality spirometry. A total of 6452 were followed up, with 5936 completing the study core questionnaire. Of these, 4044 also provided high-quality pre- and post-bronchodilator spirometry. On both occasions, the core questionnaire covered information on respiratory symptoms, doctor diagnoses, health care use, medication use and ealth status, as well as potential risk factors. Information on occupation, environmental exposures and diet was also collected

Optimizing Intermodal Trip Planning Decisions in Interurban Networks

Travel and tourism activities and trip planning decisions involving the interoperability complexities and interdependencies introduced by inter-modal and interurban transportation networks constitute an ample opportunity area for deploying the state-of-the-art mobile Internet technologies. It is becoming increasingly necessary to provide travelers with real-time information to assist them in preplanning or replanning their transport and travel activities or particular trip elements during their trip, while being on the move. Trip planning decisions, either before or during the trip realization constitute a derived demand, pushed by demand for tourism activities. However, they represent the most critical chain of the decision-making process on the grounds that they eventually determine the feasibility and the realization of the whole travel activity. From a different perspective, terminal operators, regional authorities, and other transport and tourism organizations show a vast interest and actively pursue alternative ways of dealing with the requirements of the demand for travel and tourism services. An integrated system providing value added logistical services related to travel and tourism, the World in your H@nds on the Move-WH@M system, has been implemented to support and optimize the trip planning process. A study had three objectives: to discuss the way that intermodality can be supported by such a technological application; to present the architecture, operations, and the solution approach governing the trip planning modules; and to provide a brief demonstration of the relevant trip planning modules of the system

A Critical Assessment of Airport Demand Management Strategies in Europe and U.S.:A Comparative Perspective

The ever-tighter mismatch between the demand and supply of airport services has triggered policy discussions that bring to the forefront a challenging dilemma for decision makers and the various stakeholding groups in the airport domain: demand management or capacity enhancement? There are two solutions in the effort to reduce gridlock in the air transport system—to expand capacity, and to diminish or handle demand through time and space. One part of the answer lies with technology and operations aiming at building capacity and another with balancing and handling demand. Since the last decade of continuously increasing air traffic congestion, demand management strategies have gained increasing acceptance by airport authorities and policy makers as a potential vehicle of handling demand—by limiting in some way the demand for access to busy airfields or to congested airspace or by modifying the spatial and temporal distribution of demand, or by doing both. A critical review was done of the developments, practices, and research activities in Europe and the United States toward confronting the well-known aviation capacity gridlock. A triplet of analysis formed the base: the current state of affairs pertaining to the demand and growth patterns and prospects vis-a-vis supply-side developments; the discussion of the aviation capacity gridlock; and an in-depth analysis and critical assessment of the alternative demand-side solutions under the spectrum of all potential enhancement aspects (i.e., administrative, economic, hybrid measures)

Airport slot allocation:from instruments to strategies

Slot allocation is widely used to tackle capacity shortfalls and manage delays in air traffic and airports. A variety of instruments are used, but little analysis has been conducted looking at the synergies that exist when these tools are integrated to form an overall slot allocation strategy. This paper aims to capitalise on existing research work in the field of airport slot allocation instruments to define a series of distinct and integrated strategies as the candidate strategic options for practical implementation

Advanced Modelling capabilities for airport performance assessment and Capacity Management

Airport decision makers face frequently complex decisions related to airport planning, design, and operations. These decisions are highly complicated since they involve a variety of entities processed through the system, a number of different airport elements, and a large variety of airport performance measures such as capacity, delays, safety, security, noise, and cost-effectiveness. Existing airport modeling capabilities suffer from (a) fragmentation between the various airport elements, entities, and their operations; (b) the isolated manner in which the airport performance measures are assessed and modeled; and (c) the lack of user-friendly modeling capabilities and decision support systems adopting a problem-oriented approach for airport decision making and planning. Advanced airport modeling capabilities should be deployed to integrate domain knowledge with tool expertise in assisting airport decision makers to answer frequently arising airport planning questions in an integrated, user-friendly, and problem-oriented environment. The operational concept for an integrated, problem-oriented modeling approach for total airport performance analysis is introduced, the development of a decision support system for airport performance assessment and capacity management is described, and the modeling and decision support capabilities of the system are demonstrated

Advanced Modelling capabilities for airport performance assessment and Capacity Management

Airport decision makers face frequently complex decisions related to airport planning, design, and operations. These decisions are highly complicated since they involve a variety of entities processed through the system, a number of different airport elements, and a large variety of airport performance measures such as capacity, delays, safety, security, noise, and cost-effectiveness. Existing airport modeling capabilities suffer from (a) fragmentation between the various airport elements, entities, and their operations; (b) the isolated manner in which the airport performance measures are assessed and modeled; and (c) the lack of user-friendly modeling capabilities and decision support systems adopting a problem-oriented approach for airport decision making and planning. Advanced airport modeling capabilities should be deployed to integrate domain knowledge with tool expertise in assisting airport decision makers to answer frequently arising airport planning questions in an integrated, user-friendly, and problem-oriented environment. The operational concept for an integrated, problem-oriented modeling approach for total airport performance analysis is introduced, the development of a decision support system for airport performance assessment and capacity management is described, and the modeling and decision support capabilities of the system are demonstrated

A Critical Assessment of Airport Demand Management Strategies in Europe and U.S.:A Comparative Perspective

The ever-tighter mismatch between the demand and supply of airport services has triggered policy discussions that bring to the forefront a challenging dilemma for decision makers and the various stakeholding groups in the airport domain: demand management or capacity enhancement? There are two solutions in the effort to reduce gridlock in the air transport system—to expand capacity, and to diminish or handle demand through time and space. One part of the answer lies with technology and operations aiming at building capacity and another with balancing and handling demand. Since the last decade of continuously increasing air traffic congestion, demand management strategies have gained increasing acceptance by airport authorities and policy makers as a potential vehicle of handling demand—by limiting in some way the demand for access to busy airfields or to congested airspace or by modifying the spatial and temporal distribution of demand, or by doing both. A critical review was done of the developments, practices, and research activities in Europe and the United States toward confronting the well-known aviation capacity gridlock. A triplet of analysis formed the base: the current state of affairs pertaining to the demand and growth patterns and prospects vis-a-vis supply-side developments; the discussion of the aviation capacity gridlock; and an in-depth analysis and critical assessment of the alternative demand-side solutions under the spectrum of all potential enhancement aspects (i.e., administrative, economic, hybrid measures)

Airport slot allocation:from instruments to strategies

Slot allocation is widely used to tackle capacity shortfalls and manage delays in air traffic and airports. A variety of instruments are used, but little analysis has been conducted looking at the synergies that exist when these tools are integrated to form an overall slot allocation strategy. This paper aims to capitalise on existing research work in the field of airport slot allocation instruments to define a series of distinct and integrated strategies as the candidate strategic options for practical implementation

Development and demonstration of an integrated decision support system for airport performance analysis

Airport decision makers are frequently facing complex decision-making problems related to airport planning, design, and operations. The airport decision-making process is further perplexed by the large number of stakeholders having different, and sometimes conflicting, objectives regarding the assessment of the airport performance. Despite the rich experience in both models and tools for airport performance analysis, existing models and tools address only fragmented parts of the airport decision-making process. At present, airport stakeholders lack models and tools able to provide an integrated view of the total airport processes and analyze the tradeoffs between the various measures of airport effectiveness. The objective of this paper is threefold: (i) to introduce the concept of total airport performance analysis, (ii) to describe the development of a Decision Support System capable of performing integrated airport analysis, and (iii) to demonstrate the capabilities of this Decision Support System by analyzing a real-world airport planning case of the Athens International Airport