ORCID Profile
0000-0002-9983-1212
Current Organisation
University of Western Australia
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Public Health and Health Services | Epidemiology | Biological Sciences Not Elsewhere Classified | Paediatrics | Respiratory Diseases | Community Child Health
Families | Respiratory system and diseases (incl. asthma) | Air quality | Child health | Social structure and health | Education policy |
Publisher: Wiley
Date: 11-2006
Publisher: Wiley
Date: 20-11-2013
DOI: 10.1002/PPUL.22699
Abstract: The forced oscillation technique (FOT) can be used in children as young as 2 years of age and in those unable to perform routine spirometry. There is limited information on changes in FOT outcomes in healthy children beyond the preschool years and the level of bronchodilator responsiveness (BDR) in healthy children. We aimed to create reference ranges for respiratory impedance outcomes collated from multiple centers. Outcomes included respiratory system resistance (R(rs)) and reactance (X(rs)), resonant frequency (Fres), frequency dependence of R(rs) (Fdep), and the area under the reactance curve (AX). We also aimed to define the physiological effects of bronchodilators in a large population of healthy children using the FOT. Respiratory impedance was measured in 760 healthy children, aged 2-13 years, from Australia and Italy. Stepwise linear regression identified anthropometric predictors of transformed R(rs) and X(rs) at 6, 8, and 10 Hz, Fres, Fdep, and AX. Bronchodilator response (BDR) was assessed in 508 children after 200 µg of inhaled salbutamol. Regression analysis showed that R(rs), X(rs), and AX outcomes were dependent on height and sex. The BDR cut-offs by absolute change in R(rs8), X(rs8), and AX were -2.74 hPa s L(-1), 1.93 hPa s L(-1), and -33 hPa s L(-1), respectively. These corresponded to relative and Z-score changes of -32% -1.85 for R(rs8), 65% 1.95 for X(rs8), and -82% -2.04 for AX. We have established generalizable reference ranges for respiratory impedance and defined cut-offs for a positive bronchodilator response using the FOT in healthy children.
Publisher: Elsevier BV
Date: 11-2004
Abstract: Raised exhaled nitric oxide (Feno) levels have been associated with asthma. However, we have found that in children, Feno was increased in atopic children with increased airway responsiveness (AR), and this was independent of a diagnosis of asthma. The current study was designed to test the hypothesis that in adults there is no association between Feno and asthma after controlling for atopy and AR. One hundred fifteen adults (77 women mean age, 41 years) underwent an assessment that included Feno measurements, spirometry, skin-prick testing, blood eosinophil count, and inhaled histamine challenge (results are expressed as a dose-response slope [DRS]). When only atopic in iduals were considered (n = 73), Feno was positively associated with the DRS (p = 0.003), male gender (0.02), and negatively associated with current smoking (p = 0.09). Only male gender (p = 0.03) was associated with Feno among nonatopic in iduals (n = 36). In multivariate analysis, there was no association between Feno and current asthma, current wheeze, or asthma ever. We conclude that in adult subjects, elevated Feno measurements are associated with a phenotype characterized by atopy and increased AR regardless of the presence of asthma or asthma-like symptoms.
Publisher: European Respiratory Society (ERS)
Date: 07-07-2011
DOI: 10.1183/09031936.00000811
Abstract: Malignant mesothelioma (MM) of the pleura or peritoneum is a universally fatal disease attracting an increasing range of medical interventions and escalating healthcare costs. Changes in survival and the factors affecting survival of all patients ever diagnosed with MM in Western Australia over the past five decades and confirmed by the Western Australian Mesothelioma Registry to December 2005 were examined. Sex, age, date and method of diagnosis, site of disease and histological type were recorded. Date of onset of symptoms and performance status were obtained from clinical notes for a s le of cases. Cox regression was used to examine the association of the clinical variables and the 10-yr periods of disease onset with survival after diagnosis. Survival was inversely related to age, being worse for males (hazard ratio (HR) 1.4, 95% CI 1.2-1.6), and those with peritoneal mesothelioma (HR 1.4, 95% CI 1.1-1.7). Patients with sarcomatoid histology had worse prognosis than patients with epithelioid and biphasic histological subtypes. Survival improved after the 1970s and has made incremental improvements since then. Median (interquartile range) survival by decade, from 1960 until 2005, was 64 (0-198), 177 (48-350), 221 (97-504), 238 (108-502) and 301 (134-611) days ~4 weeks of this apparent improvement can be attributed to earlier diagnosis. With increasing resources and treatment costs for MM over the past 40 yrs, there have been modest improvements in survival but no complete remissions.
Publisher: Wiley
Date: 06-11-2016
DOI: 10.1111/PPE.12324
Abstract: While there is evidence of an association between caesarean birth and increased asthma in children in high-income countries, it is unknown whether this association exists in low-to-middle-income countries (LMICs). We investigated whether children born through caesarean in India and Vietnam are at increased risk of caregiver-reported asthma by 8 years of age. Data from an ongoing multi-national longitudinal cohort study (the Young Lives Study) in two LMICs (India n = 2026 Vietnam n = 2000) were used. Caregiver questionnaires captured information on caregiver-reported long-term respiratory problems such as asthma or wheeze at age 8 years, birth mode and a range of sociodemographic factors. Multivariable logistic regression models using propensity score adjustment were used to explore birth mode and asthma at age 8 years adjusted for a range of known confounders. Children delivered by caesarean in India (odds ratio (OR) 2.6, 95% confidence interval (CI) 1.3, 5.4) and Vietnam (OR 2.0, 95% CI 1.2, 3.3) had greater odds of asthma at age 8 years, after adjustment for other risk factors including wealth, liveborn parity, low birthweight, geographic location, cooking fuel used, livestock ownership, household size, housing quality and parental smoking. The study suggests that caesarean birth may be associated with an increased risk of childhood asthma in India and Vietnam. The underlying mechanisms of this finding need to be further elucidated.
Publisher: Springer Science and Business Media LLC
Date: 14-02-2017
DOI: 10.1038/BJC.2017.20
Publisher: BMJ
Date: 06-2007
Publisher: BMJ
Date: 16-01-2012
DOI: 10.1136/THORAXJNL-2011-200236
Abstract: Unflued gas heaters (UFGHs) and cookers are a major contributor to air pollution in homes. Gas appliances have been associated with adverse respiratory outcomes in children and, less consistently, adults. There have been very few studies on the effects of gas appliances on the respiratory health of older people. This study investigated the daily lung function and respiratory symptoms of older people (>55 years of age) who did and did not use an UFGH as a primary source of heating. 71 patients with asthma were recruited for the study. Each patient participated for one 12-week winter period. All patients recorded daytime and night-time symptoms in a diary and completed morning and evening peak flow and forced expiratory volume in 1 s for the study period. General estimating equations were used to measure the associations between symptoms and lung function outcomes and same and previous day (lag 1) UFGH exposure. Same and previous day (lag 1) UFGH exposure was associated with significantly increased ORs for wheeze and dyspnoea compared with days on which no heating was used. Furthermore, there were significant increases in the average odds of reported wheeze and dyspnoea per hour of UFGH heater use. Small but significant reductions in morning to evening peak flow and forced expiratory volume in 1 s were observed on the days an UFGH was used compared with days when other heating was used or there was no heating. Exposure to UFGHs may have a detrimental effect on symptoms and lung function in older people with mild to moderate asthma.
Publisher: MDPI AG
Date: 21-03-2023
Abstract: Despite their increasing popularity, and Australia’s unique regulatory environment, how and why Australian adults use e-cigarettes and their perceptions of their safety, efficacy and regulation have not been extensively reported before. In this study, we screened 2217 adult Australians with the aim of assessing these questions in a s le of current or former e-cigarette users. A total of 505 out of 2217 respondents were current or former e-cigarette users, with only these respondents completing the full survey. Key findings of this survey included the high proportion of respondents who indicated they were currently using e-cigarettes (307 out of 2217 = 13.8%), and the high proportion of current e-cigarette users that were also smokers (74.6%). The majority of respondents used e-liquids containing nicotine (70.3%), despite it being illegal in Australia without a prescription, and the majority bought their devices and liquids in Australia (65.7%). Respondents reported using e-cigarettes in a variety of places, including inside the home, inside public places (where it is illegal to smoke tobacco cigarettes), and around other people—which has implications for second and third hand exposures. A significant proportion of current e-cigarette users (30.6%) thought that e-cigarettes were completely safe to use long-term, although in general, there was a large amount of uncertainty/ambivalence with respect to perceptions of e-cigarette safety and efficacy as smoking cessation tools. This study shows that e-cigarette use is common in Australia, and that appropriate dissemination of unbiased research findings on their safety and efficacy in smoking cessation is urgently required.
Publisher: European Respiratory Society (ERS)
Date: 09-2008
Publisher: SAGE Publications
Date: 05-2008
Abstract: Despite a growing number of studies using acoustic rhinometry (AR) in children, no reference material exists that incorporates the entire age and height interval of preschool children up to puberty for a range of rhinometric variables. The aim of this study is to provide a reference range for nasal volumes and minimum cross-sectional areas (MCAs) in healthy nondecongested children aged 4-13 years old. Two hundred fifty-six primary school children (mean, 7.95 years range, 3.8-13.1 years 123 boys/133 girls) were measured by AR. Variables were MCA (first, second, and absolute minimum) and nasal volumes from 0 to 4 cm (Vol0-4), 0 to 5 cm (Vol0-5), 1 to 4 cm (Vol1-4), and 2 to 5 cm (Vol2-5) into the nasal cavity. Height and weight were measured and atopic status was determined by skin-prick test. Age and current and past respiratory health were recorded from a questionnaire. In multiple linear regression models height was the main predictor for all AR variables although weight also was a significant predictor of MCAs. There was no association between any AR variables with sex, atopy, or hay fever but children with current wheeze (within last 12 months) and asthma had decreased nasal patency. This article presents the most extensive current reference material for AR in nondecongested prepubescent healthy children. The presented reference material will facilitate the interpretation and evaluation of future and present epidemiologic studies based on AR in children.
Publisher: Springer Science and Business Media LLC
Date: 12-01-2017
DOI: 10.1007/S00330-016-4722-7
Abstract: The correlation between ultra low dose computed tomography (ULDCT)-detected parenchymal lung changes and pulmonary function abnormalities is not well described. This study aimed to determine the relationship between ULDCT-detected interstitial lung disease (ILD) and measures of pulmonary function in an asbestos-exposed population. Two thoracic radiologists independently categorised prone ULDCT scans from 143 participants for ILD appearances as absent (score 0), probable (1) or definite (2) without knowledge of asbestos exposure or lung function. Pulmonary function measures included spirometry and diffusing capacity to carbon monoxide (DLCO). Participants were 92% male with a median age of 73.0 years. CT dose index volume was between 0.6 and 1.8 mGy. Probable or definite ILD was reported in 63 (44.1%) participants. Inter-observer agreement was good (k = 0.613, p < 0.001). There was a statistically significant correlation between the ILD score and both forced expiratory volume in 1 second (FEV Changes consistent with ILD on ULDCT correlate well with corresponding reductions in gas transfer, similar to standard CT. In asbestos-exposed populations, ULDCT may be adequate to detect radiological changes consistent with asbestosis. • Interobserver agreement for the ILD score using prone ULDCT is good. • Prone ULDCT appearances of ILD correlate with changes in spirometric observations. • Prone ULDCT appearances of ILD correlate strongly with changes in gas transfer. • Prone ULDCT may provide sufficient radiological evidence to inform the diagnosis of asbestosis.
Publisher: Wiley
Date: 02-2005
DOI: 10.1002/PPUL.20149
Abstract: In infants, the effect of colds and other respiratory tract infections (RTI) on exhaled nitric oxide (FE(NO)) is not clear. In this study, we measured FE(NO) in 24 infants (14 boys) who presented with rhinorrhea, with or without cough but not wheeze. Twelve of these infants had a history of recurrent wheeze. Levels were compared with a group of 23 healthy infants (13 boys). Further, 8 infants (5 with a history of recurrent wheeze) with rhinorrhea were tested after symptoms had resolved. Infants with rhinorrhea had significantly lower FE(NO) than the healthy infants (11.9 vs. 23.8 ppb, respectively, P < 0.0007). Levels increased from 7.5 ppb to 34.1 ppb in the 8 infants tested with and without symptoms (P = 0.0002). Infants with rhinorrhea have reduced FE(NO), irrespective of their respiratory history.
Publisher: Wiley
Date: 28-02-2017
DOI: 10.1002/AJIM.22695
Abstract: Malignant mesothelioma (MM) is a rare and generally fatal cancer, usually caused by asbestos, although about 5-10% of cases report no asbestos exposure. This study aimed to identify sources whereby people in Western Australia (WA) may be unknowingly exposed to asbestos or to other exposures which may cause MM. Cases with no known asbestos exposure were selected from the WA Mesothelioma Register (WAMR). Matched controls were selected from hospital patients admitted for conditions unrelated to asbestos. Occupational histories were coded by an industrial hygienist. Data were analyzed using conditional logistic regression. Thirty-eight MM participants and 134 controls were recruited. Risk of MM was increased (OR = 3.1, 95%CI 1.0-9.6) after no known, but likely, exposure to asbestos at work. Because of its extensive use, few people in WA have never been exposed to asbestos. Unrecognized exposure may cause most MM cases initially regarded as "no exposure." Am. J. Ind. Med. 60:432-436, 2017. © 2017 Wiley Periodicals, Inc.
Publisher: Springer Science and Business Media LLC
Date: 24-07-2015
DOI: 10.1007/S00420-014-0960-7
Abstract: To examine the effect of knowledge of radiographic abnormalities on the mental health of asbestos-exposed people with and without pleural abnormalities. Subjects were former asbestos mine and mill workers and residents of the mining town who had participated in an annual health review program. Pleural abnormalities (pleural plaques, diffuse pleural thickening and asbestosis) were determined from plain chest X-rays. All Participants completed a questionnaire on mental health status (SF-12) and locus of control (LOC). There were no significant differences between asbestos-exposed people with and without radiographic abnormalities for either the SF-12 mental health score or LOC. However, the asbestos-exposed cohorts had lower mental health scores compared with a random s le of the local population. The presence of pleural abnormalities did not further affect the mental health of asbestos-exposed people beyond a decrement associated with exposure per se.
Publisher: Oxford University Press (OUP)
Date: 10-03-2016
Publisher: Wiley
Date: 02-2006
DOI: 10.1002/PPUL.20362
Abstract: There is growing interest in investigating compounds of exhaled breath condensates (EBC) as potential noninvasive markers of airways disease processes. Some of these markers have the potential to provide information on the early stages of disease. In this paper, we present a method for collecting EBC during both oral and nasal breathing in infants. Fifty-four infants (mean age, 13.3 months range, 1-30 months) undergoing infant lung-function testing were recruited for this study. Breath condensates were collected during sedated sleep, using a custom-made collection device. Collections were made for 10 min during normal tidal breathing. Nasal measurements were attempted in all children by placing a face-mask over the nose and mouth and keeping the mouth closed. In 14 infants, oral measurements were made by placing a face-mask over the mouth only and occluding the nose. Condensates were collected successfully in all but one child. The collected volume ranged from 50-550 microl (mean +/- SD, 281.8 +/- 145.8 microl). The volume of EBC collected was correlated to age, length, weight, and minute ventilation. Significantly more EBC was collected during oral compared to nasal breathing (354.3 vs. 277.5 microl, P=0.03). There were no significant changes in heart rate, respiratory rate, or oxygen saturation during collection. The collection of EBC in young children and infants is feasible and safe, and the method used here allows the successful collection of reasonable amounts of exhaled condensate.
Publisher: BMJ
Date: 02-2005
Publisher: Informa UK Limited
Date: 07-03-2021
Publisher: Elsevier BV
Date: 05-2011
DOI: 10.1016/J.RMED.2011.01.017
Abstract: Respiratory function impacts on musical expression for wind/brass (W/B) musicians. Investigation of musicians' respiratory health to date has rarely progressed further than assessments of flow limitation through spirometry. This study aimed to compare W/B musicians' respiratory function to a non-wind/brass (NW/B) group with a comprehensive respiratory function assessment. Non-smoking, non-asthmatic participants aged 18-60 years completed a respiratory health questionnaire followed by spirometry, static lung volumes, respiratory mechanics, using forced oscillations, gas transfer and airway responsiveness (AR). Measurements were compared between participant groups using T-tests and linear regression modelling. Data from 102 participants (55 W/B musicians and 47 NW/B subjects) were included in the analysis. There were no differences between the two groups for any spirometry or lung volume outcomes, with the exception of RV/TLC which was decreased among W/B musicians (p=0.03). Measures of gas transfer and AR were similar between participant groups. Resistance at 6 Hz, measured by forced oscillation, was increased among W/B musicians compared to NW/B musicians (p=0.02) but reactance at 6 Hz was similar between the groups (p=0.10). The results suggest that W/B musicians' do not have altered respiratory function when compared to a non-musical control group. However, increased R(rs6) may indicate inflammatory, remodelling or other pathophysiological processes associated with W/B playing. Although the difference between groups was small it warrants further investigation.
Publisher: American Thoracic Society
Date: 15-11-2014
Publisher: Elsevier BV
Date: 12-2006
Publisher: Elsevier BV
Date: 2006
DOI: 10.1016/J.RMED.2005.03.033
Abstract: The collection of exhaled breath condensate (EBC) is simple and non-invasive, however, there are few data on the methodological aspects affecting concentrations of compounds in EBC. The aim of this study was to investigate methodological issues for measuring nitric oxide metabolites (NO(x)) in EBC. Twenty-five healthy adults (12 females, age range 23-55 years) and 22 children (11 females, age range 7-6 years) were recruited for studies investigating inter- and intra-day repeatability, repeatability with controlled expiratory flows and temperature, flow dependence, and analytical variability of EBC NO(x). Both intra- and inter-day repeatability was poor with a coefficient of repeatability of 103.4% of the mean difference between intra-day (15 min) measures and 118.6% of inter-day (24 h) differences. Repeatability was not improved when expiratory flow and temperature of the collection device were controlled. However, some of the variability (approximately 50%) may be accounted for by variability in the analytical technique (analytical variability) and this may result from difficulties in controlling for contamination. NO(x) levels were not affected by different expiratory flows in either adults or children but there was still significant variation within in iduals. Levels of NO(x) in EBC seem to be highly variable and this needs to be considered if EBC NO(x) is to be used in clinical studies.
Publisher: Wiley
Date: 09-08-2012
DOI: 10.1002/AJIM.22103
Abstract: There are few data on the long-term health outcomes of exposure to asbestos in childhood. This study investigated cancer and mortality of adults exposed to blue asbestos as children. Data linkage to relevant health registries was used to identify cancers and mortality in a cohort of adults (n = 2,460) that had lived in an asbestos mining town during their childhood (<15 years). There were 217 (93 female) incident cancers and 218 (70 female) deaths among the cohort. Compared with the Western Australian population females had elevated mesothelioma, ovarian and brain cancers, and increased "all cause" and "all cancer" mortality. Males had elevated mesothelioma, leukemia, prostate, brain, and colorectal cancers, and excess mortality from "all causes," "all cancers," circulatory disease, diseases of the nervous system, and accidents. Exposure to blue asbestos in childhood is associated with an increased risk of cancer and mortality in adults.
Publisher: Wiley
Date: 14-07-2015
DOI: 10.1111/RESP.12592
Abstract: Many of the pathological consequences in the lung following inhalation of asbestos fibres arise as a consequence of persistent oxidative stress and inflammation. Inflammatory responses can be observed in asymptomatic asbestos-exposed in iduals. There are currently no interventions to reduce inflammatory or oxidative responses to asbestos before disease develops. We investigated the effects of oral N-acetylcysteine (NAC) on indicators of inflammation or oxidative stress in asymptomatic people previously exposed to asbestos. A double-blind, randomized, placebo-controlled study was conducted to assess the effectiveness and safety of 1800 mg of NAC given orally over a period of 4 months. This was a proof of principle study. Effectiveness was assessed using indicators of inflammation or oxidation as primary end-points. Serum levels of total combined thiols (cysteine, cysteinylglycine, glutathione and homocysteine) were used to monitor the NAC supplementation. Thirty-four subjects were randomly allocated to NAC and 32 to placebo. Serum levels of total combined thiols were similar between the groups after intervention. There were no differences in levels of inflammatory or oxidative stress end-points between the groups. No adverse effects were identified. No evidence was found that NAC supplementation replenishes total combined thiols in the blood of healthy subjects with a history of asbestos exposure. There was also no evidence of reduced indicators of inflammation or oxidative stress. Further studies should determine the conditions required to increase levels of total anti-oxidant capacity in the blood and in the lungs of subjects with either asbestos-related diseases or subclinical lung inflammation.
Publisher: Wiley
Date: 23-01-2007
DOI: 10.1111/J.1365-2222.2007.02657.X
Abstract: Anti-oxidants are of growing interest in early treatment and prevention of allergic diseases in early life, but the effects on allergen-specific immune responses need to be documented further before intervention studies in infants are undertaken. The aim of this study in adults was to determine the effects of dietary anti-oxidants on allergen-specific immune responses in sensitized in iduals. In a randomized controlled trial, 54 allergic adults received an anti-oxidant supplement (n=36) comprising beta-carotene (9 mg/day), vitamin C (1500 mg/day), vitamin E (130 mg/day), zinc (45 mg/day), selenium (76 microg/day) and garlic (150 mg/day) or a placebo (n=18) for 4 weeks. Anti-oxidant capacity (AC), serum levels of vitamin C, vitamin E, beta-carotene and selenium, peripheral blood responses, exhaled nitric oxide (eNO), as a marker of airway inflammation, and plasma F(2) isoprostanes, as a measure of oxidative stress, were measured before and after supplementation. Anti-oxidant supplementation resulted in significant increases in serum levels of vitamin C, vitamin E, beta-carotene and selenium levels, compared with the placebo group (P<0.001). There was no change in serum AC, plasma F(2)-isoprostanes, eNO or immune responses following supplementation with anti-oxidants compared with placebo. Supplementation with anti-oxidants resulted in significantly increased levels of vitamin C, vitamin E, beta-carotene and selenium but no change in immune responses, serum AC or plasma F(2)-isoprostanes.
Publisher: Informa UK Limited
Date: 07-06-2016
Publisher: BMJ
Date: 06-2006
Publisher: Elsevier BV
Date: 04-2007
DOI: 10.1016/J.SCITOTENV.2007.01.060
Abstract: Personal monitoring of particulate matter (PM) exposure in infants is difficult. Indirect, microenvironment modelling methods are more practical. Infants spend most of their time indoors at home and the aim of this study was to investigate spatial variations in PM concentrations within homes. Three size fractions of PM - particles with an aerodynamic diameter of less than 10 microm (PM(10)), less than 2.5 microm (PM(2.5)) and total suspended particulates (TSP) - were monitored in the homes of 77 infants (0-2 years) using a multi-stage virtual impactor. In all homes PM was monitored simultaneously in the main living room at heights of 1.4 m and 0.2 m from the floor. In 26 of these homes monitoring was also conducted simultaneously in the infant's bedroom. Further, PM(10) was measured simultaneously in the living room, bedroom and child's cot in 14 homes using a real-time photometer. All homes in the study were non-smoking households. On average, there were no significant differences between concentrations of any of the different PM size fractions measured at the two heights (living room) and between living room and bedroom concentrations. However, there were only moderate correlations in concentrations between the different microenvironments and in some homes there was considerable variation between s ling sites. From the real-time measurements there seemed to be good agreement between concentrations measured in different rooms and in the cot and short-term peak concentrations at one s ling site were often mirrored at other sites. These results suggest that, although large variations in PM concentrations between rooms within homes can occur, a single monitoring station can provide a reasonable estimate of indoor concentrations.
Publisher: Wiley
Date: 16-06-2004
DOI: 10.1002/PPUL.20055
Abstract: We examined the effect of inhaled fluticasone diproprionate (FDP) on symptoms, lung function (FEV(0.5)), and exhaled nitric oxide (Fe(NO)) in infants with recurrent wheeze and raised Fe(NO). Thirty-one infants aged 6-19 months (mean, 12.7 months 12 girls) completed the study. All infants had a history of recurrent wheeze and a parental history of atopy. All children had raised Fe(NO), as determined by an offline tidal breathing technique prior to randomization. Lung function and Fe(NO) were assessed before and after 4 weeks of treatment with FDP or placebo. The parents recorded daily symptoms during the treatment period. Sixteen infants received FDP and 15 the placebo for 4 weeks. At completion of the study, infants treated with FDP had a significant reduction in Fe(NO) (35.0 ppb to 16.5 ppb) compared to those that received placebo (35.2 ppb to 30.2 ppb) (P = 0.05). Small increases in FEV(0.5) were observed in both groups, but these changes were not different between groups (P = 0.8). Symptom scores were not significantly different in either group following the intervention. We showed that a moderate dose of inhaled FDP reduces levels of Fe(NO), a potential marker of airway inflammation, even in the absence of significant changes in lung function and symptoms.
Publisher: American Physiological Society
Date: 07-2017
DOI: 10.1152/AJPLUNG.00203.2016
Abstract: Electronic cigarette usage is increasing worldwide, yet there is a paucity of information on the respiratory health effects of electronic cigarette aerosol exposure. This study aimed to assess whether exposure to electronic cigarette (e-cigarette) aerosol would alter lung function and pulmonary inflammation in mice and to compare the severity of any alterations with mice exposed to mainstream tobacco smoke. Female BALB/c mice were exposed for 8 wk to tobacco smoke, medical air (control), or one of four different types of e-cigarette aerosol. E-cigarette aerosols varied depending on nicotine content (0 or 12 mg/ml) and the main excipient (propylene glycol or glycerin). Twenty-four hours after the final exposure, we measured pulmonary inflammation, lung volume, lung mechanics, and responsiveness to methacholine. Mice exposed to tobacco cigarette smoke had increased pulmonary inflammation and responsiveness to methacholine compared with air controls. Mice exposed to e-cigarette aerosol did not have increased inflammation but did display decrements in parenchymal lung function at both functional residual capacity and high transrespiratory pressures. Mice exposed to glycerin-based e-cigarette aerosols were also hyperresponsive to methacholine regardless of the presence or absence of nicotine. This study shows, for the first time, that exposure to e-cigarette aerosol during adolescence and early adulthood is not harmless to the lungs and can result in significant impairments in lung function.
Publisher: Wiley
Date: 05-10-2016
DOI: 10.1002/PPUL.23326
Abstract: Multiple breath washout (MBW) testing with SF6 gas mixture is routinely used to assess ventilation distribution in infants. It is currently unknown whether SF6 changes tidal breathing parameters during MBW in infants. We investigated if SF6 does change tidal breathing parameters in infants and whether a separate tidal breathing trace prior to MBW testing is necessary. Tidal breathing during MBW was compared to standard tidal breathing in room air in healthy infants (n = 38), preterm infants (n = 41), and infants with cystic fibrosis (n = 41). Outcomes included inspiratory and expiratory times (TI and TE ), time to peak tidal inspiratory and expiratory flow (tPTIF and tPTEF), tidal volume (VT ), respiratory rate (f), and minute ventilation (VE ). Breath times were all significantly increased for both healthy (TE : -0.0790 [-0.10566, -0.05217] mean difference [95% confidence intervals]) and CF (-0.109 [-0.15235, -0.06607]) infants during the MBW wash-in (P < 0.001). Healthy infants and those with CF showed decreased f during MBW wash-in (P < 0.001) however, no change in VT, resulting in a decreased VE (0.154 (0.086, 0.222) and 0.128 (0.069, 0.186) for healthy and CF infants, respectively, P < 0.001). Preterm infants experienced a decreased VE during both wash-in (0.134 [0.061, 0.207] P < 0.001) and wash-out phases of MBW (P < 0.05). There are differences in tidal breathing parameters during MBW testing with SF6 in infants. It is, therefore, important to measure a separate tidal breathing trace in room air, prior to MBW testing to ensure rigour of tidal breath indices derived from analysis.
Publisher: Wiley
Date: 08-2003
DOI: 10.1034/J.1399-3038.2003.00065.X
Abstract: Exhaled nitric oxide (FENO) is raised in atopy. The mechanism for this is unclear. The aim of this study was to investigate whether the number of AAT repeats in intron 20 of the NOS1 gene, recently associated with variations in FENO in adults with asthma and cystic fibrosis, was associated with the raised FENO in healthy atopic children. Eighty-seven healthy children (44 girls, 42 atopic, age range 6-18 years) underwent measurements of FENO, spirometry, airway responsiveness and skin prick testing. Genotyping was carried out to determine the number of AAT repeats. There was no association between the number of AAT repeats and FENO in either the whole s le of healthy children (n = 87) or in the subs le of healthy atopics (n = 42). However, a greater number of atopic children had two high repeat alleles compared with non-atopic children (33.3% vs. 13.6%, respectively, p = 0.03). This suggests that variations in the NOS1 gene may contribute to atopy without this relationship being reflected by FENO.
Publisher: European Respiratory Society (ERS)
Date: 10-2006
DOI: 10.1183/09031936.06.00007206
Abstract: The present study investigated the association between reported parental smoking and exhaled nitric oxide fraction (F(eNO)) in young children. In total, 78 children (24 females, mean age 51.3 weeks) were recruited. Fourteen lived with one smoking parent and eight with two smoking parents. F(eNO) was measured using the modified single-breath technique. Mean+/-sd F(eNO) levels were 33.0+/-18.9, 38.3+/-15.0 and 48.3+/-14.7 ppb for children with no, one and two smoking parents, respectively. There was a significant linear trend across the groups and, after controlling for other relevant factors, a significant difference between the groups. In the present study, exposure to environmental tobacco smoke was associated with increased exhaled nitric oxide fraction in young children. Furthermore, there was evidence of a dose-response relationship between childhood exhaled nitric oxide fraction and the number of smoking parents.
Publisher: Wiley
Date: 16-06-2016
DOI: 10.1111/RESP.12826
Abstract: Computed tomography (CT)-based studies of asbestos-exposed in iduals report a high prevalence of lung cancer, but the utility of low dose CT (LDCT) to screen asbestos-exposed populations is not established. We aimed to describe the prevalence of indeterminate pulmonary nodules and incidental findings on chest LDCT of asbestos-exposed subjects in Western Australia. A total of 906 subjects from the Western Australian Asbestos Review Programme underwent LDCT of the chest as part of regular annual review. An indeterminate (solid) nodule was defined as >50 mm Subjects were mostly (81%) men with a median age of 70 years. Fifty-eight (6.5%) participants were current smokers, 511 (56.4%) ex-smokers and 325 (36.4%) never-smokers. One hundred and four indeterminate nodules were detected in 77 subjects (8.5%) of these, eight cases had confirmed lung cancer (0.88%). Eighty-seven subjects (9.6%) had incidental findings that required further investigation, 42 (4.6%) from lower airways inflammation. The majority of nodules were solid, 4-6 mm and more common with age. Five hundred and eighty (64%) subjects had pleural plaques, and 364 (40.2%) had evidence of interstitial lung disease. The prevalence of LDCT-detected indeterminate lung nodules in 906 in iduals with significant asbestos exposure was 8.5%, lower than many other CT studies. Clinically important incidental findings were found in 9.4%, predominantly related to lower respiratory tract inflammation. LDCT appears to effectively describe asbestos-related diseases and is likely to be an acceptable modality to monitor asbestos-exposed in iduals.
Publisher: Oxford University Press (OUP)
Date: 03-04-2015
Abstract: Occupational exposure data on asbestos are limited and poorly integrated in Australia so that estimates of disease risk and attribution of disease causation are usually calculated from data that are not specific for local conditions. To develop a job-exposure matrix (AsbJEM) to estimate occupational asbestos exposure levels in Australia, making optimal use of the available exposure data. A dossier of all available exposure data in Australia and information on industry practices and controls was provided to an expert panel consisting of three local industrial hygienists with thorough knowledge of local and international work practices. The expert panel estimated asbestos exposures for combinations of occupation, industry, and time period. Intensity and frequency grades were estimated to enable the calculation of annual exposure levels for each occupation-industry combination for each time period. Two indicators of asbestos exposure intensity (mode and peak) were used to account for different patterns of exposure between occupations. Additionally, the probable type of asbestos fibre was determined for each situation. Asbestos exposures were estimated for 537 combinations of 224 occupations and 60 industries for four time periods (1943-1966 1967-1986 1987-2003 ≥2004). Workers in the asbestos manufacturing, shipyard, and insulation industries were estimated to have had the highest average exposures. Up until 1986, 46 occupation-industry combinations were estimated to have had exposures exceeding the current Australian exposure standard of 0.1 f ml(-1). Over 90% of exposed occupations were considered to have had exposure to a mixture of asbestos varieties including crocidolite. The AsbJEM provides empirically based quantified estimates of asbestos exposure levels for Australian jobs since 1943. This exposure assessment application will contribute to improved understanding and prediction of asbestos-related diseases and attribution of disease causation.
Publisher: European Respiratory Society (ERS)
Date: 02-2006
DOI: 10.1183/09031936.06.00071005
Abstract: Fractional exhaled nitric oxide (F(eNO)) has been reported to be reduced in cystic fibrosis (CF) patients. However, data from young children are conflicting and it is not clear whether this is a primary feature of the disease or a secondary response. The present study compared F(eNO) between CF and healthy infants using a validated single-breath technique. A total of 23 healthy infants (11 females mean age 40.1 weeks) and 18 infants with CF (nine females 64.9 weeks) underwent tests of lung function and F(eNO). Bronchoalveolar lavage (BAL) was collected from all CF infants 2-5 days after lung function testing. There was no significant difference in F(eNO) between the CF and healthy infants (geometric mean: 23.1 parts per billion (ppb) and 17.0 ppb, respectively). There was an inverse relationship between age and F(eNO) in the CF patients, but not in the healthy group. Within the CF group, there was no association between F(eNO) and any marker of airway inflammation measured in the BAL. Exhaled nitric oxide is not reduced in cystic fibrosis infants, but does decrease with age. The current data indicate that F(eNO) is not a good marker of airway inflammation in cystic fibrosis.
Publisher: European Respiratory Society (ERS)
Date: 14-03-2007
DOI: 10.1183/09031936.00123206
Abstract: The aim of the present study was to assess the effects of possible interactions between beta(2)-adrenoceptor gene polymorphisms and passive smoking on forced expiratory volume in one second (FEV(1)), forced vital capacity (FVC) and exhaled nitric oxide (eNO) in children aged 11 yrs. A cross-sectional analysis of the longitudinal cohort was conducted for associations between beta(2)-adrenoceptor gene polymorphisms and lung function and eNO with regard to passive smoking. Among children exposed to tobacco smoke, those with Arg16 (at least one Arg allele) exhibited lower adjusted mean FEV(1) (2.19 versus 2.38 L) and FVC (2.43 versus 2.64 L) than Gly16 homozygotes. Those with Gln27 (at least one Gln allele) also exhibited a lower adjusted mean FEV(1) relative to Glu27 homozygotes (2.24 versus 2.39 L). Among children with no exposure to smoking, those with Arg16 or Gln27 showed lower adjusted geometric mean eNO levels compared with Gly16 homozygotes (15.4 versus 30.9 ppb) and Glu27 homozygotes (18.0 versus 49.7 ppb). In conclusion, passive smoking had a significant effect on associations between beta(2)-adrenoceptor gene polymorphisms and asthma-related phenotypes, enhancing the relationship between Arg16 and lung function and removing the relationship between Arg16 or Gln27 and exhaled nitric oxide levels.
Publisher: SAGE Publications
Date: 10-05-2013
Abstract: Mould in schools has been associated with increased upper airway obstruction in adults. In this study, we investigated the relationship between school indoor mould spore exposure and nasal patency in children. Airborne mould s les were collected in 32 classrooms from 4 primary schools during both summer and winter using a single-stage Anderson s ler. Nasal patency was measured in 275 children in summer and 200 children in winter using acoustic rhinometry. Various mould species were isolated but the most common species found inside the classrooms were Alternaria, Aspergillus niger, Cladosporium spp. and Penicillium spp. In the univariate analyses, significant negative correlations were found between exposure to various mould species, particularly Alternaria, and rhinometric measures in the children. In multivariate analyses, exposure to Alternaria was associated with both decreased mean nasal cross-sectional area ( p = 0.001) and decreased nasal volume ( p = 0.026). Decreased nasal patency was also associated with exposure to A. niger ( p = 0.034) and Penicillium ( p = 0.043) in the classrooms. The findings of this study suggest that exposure to airborne mould, particularly Alternaria, in school environments may affect the upper airways of children.
Publisher: Elsevier BV
Date: 08-2016
Abstract: To describe the incidence of malignant mesothelioma (MM) in Aboriginal people in Western Australia (WA) and determine the main routes of exposure to asbestos in this population. All MM cases in Western Australia, as well as the primary source of asbestos exposure, are recorded in the WA Mesothelioma Register. Aboriginal cases up to the end of 2013 were extracted from the register and compared with non-Aboriginal cases with respect to the primary means/source of exposure. Age-standardised incidence rates for each decade from 1980 were calculated for both Aboriginals and non-Aboriginals. Age-standardised mortality rates were calculated for the period 1994-2008 and compared with international rates. There were 39 cases (77% male) of MM among WA Aboriginal people. Twenty-six (67%) were a direct result of the mining of crocidolite at Wittenoom and the subsequent contamination of the surrounding lands. Of the non-Aboriginal MM cases (n = 2070, 86.3% male), fewer than 25% can be attributed to Wittenoom. Aboriginals had consistently higher 10-year incidence rates than non-Aboriginals and, when compared to world populations, the highest mortality rate internationally. When incidence rates in Aboriginal people are compared with non-Aboriginal people, the Wittenoom mining operation has had a disproportionate effect on MM incidence in the local Aboriginal population.
Publisher: AMPCo
Date: 09-2015
DOI: 10.5694/MJA15.00337
Publisher: Walter de Gruyter GmbH
Date: 2011
Abstract: The fast growing economies and continued urbanization in Asian countries have increased the demand for mobility and energy in the region, resulting in high levels of air pollution in cities from mobile and stationary sources. In contrast, low level of urbanization in Australia produces low level of urban air pollution. The World Health Organization estimates that about 500,000 premature deaths per year are caused by air pollution, leaving the urban poor particularly vulnerable since they live in air pollution hotspots, have low respiratory resistance due to bad nutrition, and lack access to quality health care. Identifying the differences and similarities of air pollution levels and its impacts, between Indonesia and Australia, will provide best lesson learned to tackle air pollution problems for Pacific Basin Rim countries.
Publisher: BMJ
Date: 12-2003
DOI: 10.1136/THORAX.58.12.1048
Abstract: Exhaled nitric oxide (FE(NO)) is raised in asthmatic children, but there are inconsistencies in the relationship between FE(NO) and characteristics of asthma, including atopy, increased airway responsiveness (AR), and airway inflammation. The aim of this study was to investigate the relationship between FE(NO) and asthma, atopy, and increased AR in children. One hundred and fifty five children (79 boys) of mean age 11.5 years underwent an assessment that included FE(NO) measurements, spirometric tests, inhaled histamine challenge, and a skin prick test. Blood was collected for eosinophil count. Current and past asthma like symptoms were determined by questionnaire. In multiple linear regression analyses FE(NO) was associated with atopy (p<0.001), level of AR (p = 0.005), blood eosinophil count (p = 0.007), and height (p = 0.002) but not with physician diagnosed asthma (p = 0.1) or reported wheeze in the last 12 months (p = 0.5). Separate regression models were conducted for atopic and non-atopic children and associations between FE(NO) and AR, blood eosinophils and height were only evident in atopic children. Exhaled NO was raised in children with a combination of atopy and increased AR independent of symptoms. Raised FE(NO) seems to be associated with an underlying mechanism linking atopy and AR but not necessarily respiratory symptoms.
Publisher: MDPI AG
Date: 07-08-2023
DOI: 10.3390/SU151512071
Abstract: Asbestos remains ubiquitous in the Australian built environment. Of the 13 million tonnes of asbestos products installed in earlier decades, an estimated 50% remain in situ today. Because of the extensive past use of asbestos, and the increasing age of these products, the potential for exposure to asbestos fibres in both indoor and outdoor environments remains high, even while the actual asbestos exposure levels are mostly very low. Sources of these exposures include disturbance of in situ asbestos-containing materials (ACMs), for ex le during renovations or following disaster events such as fires, cyclones and floods. Our understanding of the risk of asbestos-related disease arising from long-term low-level or background exposure, however, is poor. We provide the most up-to-date review of asbestos exposure risks currently affecting different groups of the Australian population and the settings in which this can manifest. From this, a need for low-level asbestos monitoring has emerged, and further research is required to address whether current exposure monitoring approaches are adequate. In addition, we make the case for proactive asbestos removal to reduce the risk of ongoing asbestos contamination and exposure due to deteriorating, disturbed or damaged ACMs, while improving long-term building sustainability, as well as the sustainability of limited resources.
Publisher: American Thoracic Society
Date: 15-12-2008
Publisher: AMPCo
Date: 09-2011
DOI: 10.5694/MJA11.10125
Abstract: To determine trends in incidence of malignant mesothelioma (MM) caused by exposure to asbestos during home maintenance and renovation. Using the Western Australian Mesothelioma Register, we reviewed all cases of MM diagnosed in WA from 1960 to the end of 2008, and determined the primary source of exposure to asbestos. Categories of exposure were collapsed into seven groups: asbestos miners and millers from Wittenoom all other asbestos workers residents from Wittenoom home maintenance/renovators other people exposed but not through their occupation and people with unknown asbestos exposure or no known asbestos exposure. Latency periods and age at diagnosis for each group were calculated and compared. In WA, 1631 people (1408 men, 223 women) were diagnosed with MM between 1960 and 2008. Since 1981, there have been 87 cases (55 in men) of MM attributed to asbestos exposure during home maintenance and renovation, and an increasing trend in such cases, in both men and women. In the last 4 years of the study (2005-2008), home renovators accounted for 8.4% of all men and 35.7% of all women diagnosed with MM. After controlling for sex and both year and age at diagnosis, the latency period for people exposed to asbestos during home renovation was significantly shorter than that for all other exposure groups, but the shorter follow-up and difficulty recalling when exposure first occurred in this group may partly explain this. MM after exposure to asbestos during home renovation is an increasing problem in WA, and these cases seem to have a shorter latency period than other types of exposure. MM cases related to renovation will probably continue to increase because of the many homes that have contained, and still contain, asbestos building products.
Publisher: MDPI AG
Date: 24-07-2019
Abstract: Indigenous children have much higher rates of ear and lung disease than non-Indigenous children, which may be related to exposure to high levels of geogenic (earth-derived) particulate matter (PM). The aim of this study was to assess the relationship between dust levels and health in Indigenous children in Western Australia (W.A.). Data were from a population-based s le of 1077 Indigenous children living in 66 remote communities of W.A. ( ,000,000 km2), with information on health outcomes derived from carer reports and hospitalisation records. Associations between dust levels and health outcomes were assessed by multivariate logistic regression in a multi-level framework. We assessed the effect of exposure to community s led PM on epithelial cell (NuLi-1) responses to non-typeable Haemophilus influenzae (NTHi) in vitro. High dust levels were associated with increased odds of hospitalisation for upper (OR 1.77 95% CI [1.02–3.06]) and lower (OR 1.99 95% CI [1.08–3.68]) respiratory tract infections and ear disease (OR 3.06 95% CI [1.20–7.80]). Exposure to PM enhanced NTHi adhesion and invasion of epithelial cells and impaired IL-8 production. Exposure to geogenic PM may be contributing to the poor respiratory health of disadvantaged communities in arid environments where geogenic PM levels are high.
Publisher: Elsevier BV
Date: 12-2013
Publisher: European Respiratory Society (ERS)
Date: 03-2004
DOI: 10.1183/09031936.04.00084604
Abstract: The aim of this study was to compare two different methods, tidal breathing (TB) and single-breath (SB), for measuring fractional exhaled nitric oxide (FENO) in infants. FENO was measured in 71 infants with either recurrent wheeze (n=32), recurrent cough (n=16) or no symptoms (healthy, n=23) using both methods. For TB measurements five breaths were collected into a gas s ling bag (off-line reservoir s ling). The SB method was modified from the raised volume rapid thoraco-abdominal technique. Agreement between the two methods was investigated and both methods were used to compare FENO in infants with and without symptoms. Flow dependence of SB FENO was demonstrated using two expiratory flows (11 and 40 mL x s(-1)). There was a moderate correlation (r=0.60) but poor agreement between levels using the TB and SB methods. A significant difference in FENO between healthy children and children with wheeze was found using the SB but not the TB method. Due to lower expiratory flow and reduced nasal nitric oxide contamination the single-breath technique may be more sensitive than the tidal breathing method for detecting differences in exhaled nitric oxide between infants with and without respiratory symptoms.
Publisher: BMJ
Date: 19-08-2016
DOI: 10.1136/OEMED-2016-103721
Abstract: Malignant mesothelioma (MM) has distinct histological subtypes (epithelioid, sarcomatoid and biphasic) with variable behaviour and prognoses. It is well recognised that survival time varies with the histological subtype of MM. It is not known, however, if asbestos exposure characteristics (type of asbestos, degree of exposure) are associated with different histological subtypes. To determine if the pathological MM subtype is associated with the type of asbestos or the attributes of asbestos exposure. Cases of MM for the period 1962 until 2012, their main histological subtype and their most significant source of asbestos exposure were collected from the Western Australian Mesothelioma Registry. Exposure characteristics included, degree of asbestos exposure (including total days exposed, years since first exposure and, for crocidolite only, calculated cumulative exposure), source of exposure (occupational or environmental), form of asbestos handled (raw or processed) and type of asbestos (crocidolite only or mixed fibres). Patients with the biphasic subtype were more likely to have occupational exposure (OR 1.83, 1.12 to 2.85) and exposure to raw fibres (OR 1.58, 1.19 to 2.10). However, differences between subtypes in the proportions with these different exposure characteristics were small and unlikely to be biologically relevant. Other indicators of asbestos exposure were not associated with the histological subtype of mesothelioma. There was no strong evidence of a consistent role of asbestos exposure indicators in determining the histological subtype of MM.
Publisher: Wiley
Date: 15-09-2023
DOI: 10.1111/RESP.14593
Publisher: Wiley
Date: 2004
DOI: 10.1002/PPUL.10382
Abstract: Exhaled nitric oxide (FENO) may provide a tool for identifying infants at risk of developing allergic disease in childhood. In infants there is no standardized collection technique however, the easiest method is to measure FENO during tidal breathing. In this study we investigated various methodological issues for tidal breathing (TB) FENO in infants. These included the effect of ambient NO, oral or nasal breathing, sedation, and tidal expiratory flow. Furthermore, we compared TB FENO in 88 infants with and without wheeze. Ambient NO greater than 5 ppb significantly affected FENO. There was no significant difference between NO levels measured during either oral or nasal breathing however, there was a significant difference between levels collected from infants before and after sedation (P < 0.001). Tidal breathing FENO decreased with increasing tidal flows (P < 0.001) and increased with age (P = 0.002). There was no significant difference in mixed expired NO between healthy and wheezy children, but children with doctor-diagnosed eczema had significantly raised levels (P = 0.014). There seem to be important methodological limitations for measuring FENO in infants during TB.
Publisher: Elsevier BV
Date: 06-2008
DOI: 10.1016/J.PRRV.2007.12.004
Abstract: Since exhaled nitric oxide (FeNO) was first demonstrated to be raised in asthmatic patients in the early 1990s, there has been a strong interest in its potential role in the diagnosis and management of asthma. This culminated in 2003 when the US Food and Drug Administration cleared the NIOX nitric oxide analyser for clinical application in patients with asthma. The interest in FeNO is based on the assumptions that FeNO is a marker of asthma and asthma control, and that it reflects eosinophilic airway inflammation. However, the literature remains unconvincing and inconclusive. Furthermore, studies which have management algorithms that include FeNO as a guide to asthma treatment have failed to observe any improvement in asthma control compared with the use of standard asthma guidelines. At present, the cost of including FeNO in management guidelines far outweighs any potential benefits.
Publisher: Springer Science and Business Media LLC
Date: 08-09-2023
Publisher: Elsevier BV
Date: 07-2009
Abstract: Adenosine-5'-monophosphate (AMP) is an indirect challenge agent thought to reflect allergic airway inflammation. The forced oscillation technique (FOT) is ideal for use in young children and is suitable for inhaled challenge studies in patients who are in this age group. We assessed the agreement between a shortened and a standard AMP challenge and the repeatability of the shortened AMP challenge using FOT as a primary outcome variable. Eighteen children completed a shortened and a standard AMP challenge, and 20 children completed repeated shortened AMP challenges. The children inhaled nebulized AMP tidally for 2 min, following which the presence of wheeze and pulse oximetric saturation (Spo(2)) was recorded prior to FOT measurement. Testing continued until the maximum dose was reached or until wheeze, a decrease in Spo(2) to < 90%, or an increase in respiratory resistance at 8 Hz of 2.0 hPa/s/L or 30% was noted. Concordance was assessed as a binary response, and agreement in provocation concentrations (PCs) causing a response was assessed with intraclass correlations. There was a high degree of concordance between the shortened and standard AMP protocols (94%) and repeated shortened AMP protocols (100%). The mean log(10) PCs displayed a high degree of agreement for both AMP protocols, with intraclass correlation coefficients of 0.94 (95% confidence interval, 0.85 to 0.98) and 0.94 (95% confidence interval, 0.82 to 0.98), respectively. We demonstrated that a shortened AMP challenge that can be applied to young children is comparable to the standard AMP challenge and is highly repeatable. Further studies in young children to assess the clinical role of a shortened AMP challenge using FOT are required.
Publisher: BMJ
Date: 07-10-2014
Abstract: Studies have linked air pollution with the incidence of acute coronary artery events and cardiovascular mortality but the association with out-of-hospital cardiac arrest (OHCA) is less clear. To examine the association of air pollution with the occurrence of OHCA. Electronic bibliographic databases (until February 2013) were searched. Search terms included common air pollutants and OHCA. Studies of patients with implantable cardioverter defibrillators and OHCA not attended by paramedics were excluded. Two independent reviewers (THKT and TAW) identified potential studies. Methodological quality was assessed by the Newcastle-Ottawa Scale. Of 849 studies, 8 met the selection criteria. Significant associations between particulate matter (PM) exposure (especially PM(2.5)) and OHCA were found in 5 studies. An increase of OHCA risk ranged from 2.4% to 7% per interquartile increase in average PM exposure on the same day and up to 4 days prior to the event. A large study found ozone increased the risk of OHCA within 3 h prior to the event. The strongest risk OR of 3.8-4.6% per 20 parts per billion ozone increase of the average level was within 2 h prior to the event. Similarly, another study found an increased risk of 18% within 2 days prior to the event. Larger studies have suggested an increased risk of OHCA with air pollution exposure from PM(2.5) and ozone.
Start Date: 05-2008
End Date: 12-2013
Amount: $436,180.00
Funder: Australian Research Council
View Funded ActivityStart Date: 12-2005
End Date: 12-2010
Amount: $385,839.00
Funder: Australian Research Council
View Funded Activity