The National Academies Press

Currently Skimming:

Pages 240-276

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.

From page 240... ... 240 5 RESPIRATORY OUTCOMES This chapter focuses on several long-term respiratory conditions: asthma, chronic bronchitis, emphysema, and chronic obstructive pulmonary disease (COPD) Read the entire page →
From page 241... ... RESPIRATORY OUTCOMES 241 series studies do not consider pre-existing conditions and report on acute outcomes rather than long-term health effects. For relevance to Gulf War veterans, the committee focused on longterm respiratory effects that persist after exposure ceases (see Chapter 2) Read the entire page →
From page 242... ... 242 GULF WAR AND HEALTH Asthma Occupational factors are estimated to account for about 15% of the total burden of adult asthma (Balmes et al. Read the entire page →
From page 243... ... RESPIRATORY OUTCOMES 243 The committee concludes, from its assessment of the epidemiologic literature, that there is inadequate/insufficient evidence to determine whether an association exists between exposure to fuels and any specific, nonmalignant respiratory outcomes including asthma, bronchitis, and emphysema. COMBUSTION PRODUCTS AND RESPIRATORY OUTCOMES The committee divided the epidemiologic literature of respiratory effects and exposure to combustion products into four general types: studies of Gulf War veterans exposed to oil-well fires, community air pollution studies, occupational studies, and studies of biomass fuel, which is burned for heating or cooking primarily in developing countries. Read the entire page →
From page 244... ... 244 GULF WAR AND HEALTH Reference Population Exposed Cases Estimated Relative Risk (95% CI) Read the entire page →
From page 245... ... RESPIRATORY OUTCOMES 245 Reference Population Exposed Cases Estimated Relative Risk (95% CI) Bronchitis Cohort StudiesMortality Rushton and Alderson 1981 UK oil refinery-workers (range of ICD-8 codes used) Read the entire page →
From page 246... ... 246 GULF WAR AND HEALTH Reference Population Exposed Cases Estimated Relative Risk (95% CI) Time since employment, 20-39 years 10 0.40 Time since employment, 40+ years 47 0.68 Wong et al. Read the entire page →
From page 247... ... RESPIRATORY OUTCOMES 247 locations with modeled oil-fire smoke exposure. National Oceanic and Atmospheric Administration (NOAA) Read the entire page →
From page 249... ... 249 R ef er en ce T yp e of S tu dy an d Po pu la tio n E xp os ur e D et er m in at io n H ea lth O ut co m e an d H ow M ea su re d R es ul ts A dj us te d O R (9 5% C I or p ) Read the entire page →
From page 250... ... 250 GULF WAR AND HEALTH Self-reported oil-well fire smoke exposure was associated with a higher risk of asthma (OR [odds ratio] Read the entire page →
From page 251... ... RESPIRATORY OUTCOMES 251 study is reported here because it was antecedent to a more detailed study of respiratory hospitalizations by Smith et al. Read the entire page →
From page 252... ... 252 GULF WAR AND HEALTH Outdoor Air Pollution Community air-pollution studies typically evaluate the health effects of routinely measured air pollutants, such as nitrogen oxides (NOx) , sulfur dioxides, particles of various sizes (for example, PM10, PM2.5) Read the entire page →
From page 253... ... RESPIRATORY OUTCOMES 253 individual pollutants, exposure groupings (for example, mean concentrations or exceedance frequencies) , and time frames. Read the entire page →
From page 254... ... 254 GULF WAR AND HEALTH 95% CI 0.98 to 3.25) Read the entire page →
From page 255... ... RESPIRATORY OUTCOMES 255 reduced the accuracy of exposure classification; and the wide confidence intervals, reflecting low precision of the effect estimates, limit interpretation of the data. In a population-based sample of adults aged 40 years or older, investigators studied the relation between regional SO2 concentration in the Osaka prefecture in Japan and the prevalence of self-reported chronic bronchitis (Tsunetoshi et al. Read the entire page →
From page 256... ... 256 GULF WAR AND HEALTH complicating matters, emphysema deaths are often caused by pneumonia or cardiovascular disease, so ascertainment of emphysema deaths is not robust. Respiratory mortality findings in several large-scale cohorts have been reported: American Cancer Society (ACS) Read the entire page →
From page 257... ... RESPIRATORY OUTCOMES 257 NOx were assessed to estimate long-term exposure to outdoor air pollution. The trend for TSP was Lanzhou > Wuhan-urban > Guangzhou > Wuhan-suburban. Read the entire page →
From page 258... ... 258 GULF WAR AND HEALTH study used a composite upper respiratory disease definition that included upper and lower respiratory tract diseases. No specific information on asthma, chronic bronchitis, or COPD was presented. Read the entire page →
From page 259... ... RESPIRATORY OUTCOMES 259 Occupational Studies Osterman et al. Read the entire page →
From page 260... ... 260 GULF WAR AND HEALTH deaths) , which included a mix of urban and rural firefighting jurisdictions, did not find higher mortality from COPD (Burnett et al. Read the entire page →
From page 261... ... RESPIRATORY OUTCOMES 261 transport workers have an increased risk of physician-diagnosed asthma (PR 116, 95% CI 101131) , but no measurements of exposure were available. Read the entire page →
From page 262... ... 262 GULF WAR AND HEALTH clean fuels (OR 1.59, 95% CI 1.30-1.94) Read the entire page →
From page 263... ... RESPIRATORY OUTCOMES 263 their homes were likely to have been poorly ventilated. The cross-sectional prevalence of chronic bronchitis increased with hours spent near the fireplace. Read the entire page →
From page 264... ... 264 GULF WAR AND HEALTH prevalence of chronic bronchitis than using a kerosene stove, liquefied petroleum gas, or mixed fuel (2.9% vs 1.3%, 2.5%, and 1.2%, respectively; p < 0.05) Read the entire page →
From page 266... ... 266 R ef er en ce T yp e of S tu dy an d Po pu la tio n E xp os ur e D et er m in at io n H ea lth O ut co m e an d H ow M ea su re d R es ul ts A dj us te d O R (9 5% C I o r p) Read the entire page →
From page 267... ... RESPIRATORY OUTCOMES 267 Chronic Bronchitis Chronic bronchitis is defined by symptoms of chronic cough and sputum production. A major prospective study of outdoor air pollution with more than a decade of exposure (Abbey et al. Read the entire page →
From page 269... ... RESPIRATORY OUTCOMES 269 Consequently, even if it could be shown that long-term exposure to combustion products caused chronic bronchitis, it might be expected to remit after exposure cessation without longterm health consequences. The committee found inadequate published data to evaluate the natural history of chronic bronchitis after cessation of exposure to combustion products. Read the entire page →
From page 270... ... 270 GULF WAR AND HEALTH endpoints selected for examination in those studies cannot be specifically linked to the pathogenesis of any particular respiratory disease. REFERENCES Abbey DE, Colome SD, Mills PK, Burchette R, Beeson WL, Tian Y Read the entire page →
From page 271... ... RESPIRATORY OUTCOMES 271 Behera D, Jindal SK. Read the entire page →
From page 272... ... 272 GULF WAR AND HEALTH Dunn CE, Woodhouse J, Bhopal RS, Acquilla SD. Read the entire page →
From page 273... ... RESPIRATORY OUTCOMES 273 Kanner RE, Connett JE, Williams DE, Buist AS. Read the entire page →
From page 274... ... 274 GULF WAR AND HEALTH Osterman JW, Greaves IA, Smith TJ, Hammond SK, Robins JM, Theriault G Read the entire page →
From page 275... ... RESPIRATORY OUTCOMES 275 Reijula K, Haahtela T, Klaukka T, Rantanen J . Read the entire page →
From page 276... ... 276 GULF WAR AND HEALTH Willemse BW, Postma DS, Timens W, ten Hacken NH. Read the entire page →

From page 240...

... 240 5 RESPIRATORY OUTCOMES This chapter focuses on several long-term respiratory conditions: asthma, chronic bronchitis, emphysema, and chronic obstructive pulmonary disease (COPD)