Lung functions and respiratory symptoms among rice millers in Anuradhapura district, Sri Lanka

Objectives: Rice is the most important crop cultivated in Sri Lanka and rice milling is the largest agro-based industry in the country. The general objective of this study was to identify and quantify the effects of inhalation of rice husk dust on the respiratory function of the rice millers in Anuradhapura district, Sri Lanka.Methods: Rice millers (male: 84, female: 84) and controls (male: 84, female: 84) were selected and matched for determinants of lung functions, including smoking pack year index. Data were collected via a validated respiratory symptom and occupational history questionnaire, a physical examination and spirometry. Subjects with a known history of respiratory or cardiac diseases were excluded from the study. Results: The rice millers, irrespective of gender, had significantly lower mean forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and peak expiratory flow rate (PEFR) values (p<0.05) and increased prevalences of respiratory symptoms when compared with controls. Among millers, 42% of males and 38% of females had features of chronic respiratory disease. Further, the mean FEV1/FVC ratio was significantly higher among male millers, while the mean mid expiratory flow rate (FEF25-75%) was significantly lower among female millers, than their respective controls. Exposure to the dust over a few hours caused significant reductions in FVC and FEV1 in female millers. Conclusions: The observed deficiencies in lung functions of rice millers were probably caused by the occupational exposure to rice husk dust. Wearing face masks, worker education and adequate ventilation in mills are recommended

Prevalence of gastro-oesophageal reflux disease symptoms and reflux-associated respiratory symptoms in asthma

<p>Abstract</p> <p>Background</p> <p>Gastro-oesophageal reflux disease (GORD) symptoms are common in asthma and have been extensively studied, but less so in the Asian continent. Reflux-associated respiratory symptoms (RARS) have, in contrast, been little-studied globally. We report the prevalence of GORD symptoms and RARS in adult asthmatics, and their association with asthma severity and medication use.</p> <p>Methods</p> <p>A cross-sectional analytical study. A validated interviewer-administered GORD scale was used to assess frequency and severity of seven GORD symptoms. Subjects were consecutive asthmatics attending medical clinics. Controls were matched subjects without respiratory symptoms.</p> <p>Results</p> <p>The mean (SD) composite GORD symptom score of asthmatics was significantly higher than controls (21.8 (17.2) versus 12.0 (7.6); <it>P </it>< 0.001) as was frequency of each symptom and RARS. Prevalence of GORD symptoms in asthmatics was 59.4% (95% CI, 59.1%-59.6%) versus 28.5% in controls (95% CI, 29.0% - 29.4%). 36% of asthmatics experienced respiratory symptoms in association with both typical and atypical GORD symptoms, compared to 10% of controls (<it>P </it>< 0.001). An asthmatic had a 3.5 times higher risk of experiencing a GORD symptom after adjusting for confounders (OR 3.5; 95% CI 2.5-5.3). Severity of asthma had a strong dose-response relationship with GORD symptoms. Asthma medication use did not significantly influence the presence of GORD symptoms.</p> <p>Conclusions</p> <p>GORD symptoms and RARS were more prevalent in a cohort of Sri Lankan adult asthmatics compared to non-asthmatics. Increased prevalence of RARS is associated with both typical and atypical symptoms of GORD. Asthma disease and its severity, but not asthma medication, appear to influence presence of GORD symptoms.</p