Transportation noise exposure, noise annoyance and respiratory health in adults: A repeated-measures study.
Environ Int. 2018 Oct 12;121(Pt 1):741-750
Authors: Eze IC, Foraster M, Schaffner E, Vienneau D, Héritier H, Pieren R, Thiesse L, Rudzik F, Rothe T, Pons M, Bettschart R, Schindler C, Cajochen C, Wunderli JM, Brink M, Röösli M, Probst-Hensch N
Transportation noise leads to sleep disturbance and to psychological and physiological sustained stress reactions, which could impact respiratory health. However, epidemiologic evidence on associations of objective transportation noise exposure and also perceived noise annoyance with respiratory morbidity is limited. We investigated independent associations of transportation noise exposure and noise annoyance with prevalent respiratory symptoms and incident asthma in adults. Using 17,138 observations (from 7049 participants) from three SAPALDIA (Swiss Cohort Study on Lung and Heart Diseases in Adults) surveys, we assessed associations of transportation noise exposure and noise annoyance with prevalent respiratory symptoms, and with incident asthma (in 10,657 nested observations from 6377 participants). Annual day-evening-night transportation noise comprising road, railway and aircraft Lden (Transportation Lden) was calculated for the most exposed façade of participants' residence using Swiss noise models. Transportation noise annoyance was assessed using an 11-point scale, and participants reported respiratory symptoms and doctor-diagnosed asthma at each survey. We estimated associations with transportation Lden (as well as source-specific Lden) and noise annoyance, independent of air pollution and other potential confounders, using mutually-adjusted mixed logistic and Poisson models and applying random intercepts at the level of the participants. Prevalent respiratory symptoms ranged from 5% (nocturnal dyspnoea) to 23% (regular cough/phlegm). Transportation noise annoyance, but not Lden, was independently associated with respiratory symptoms and current asthma in all participants, with odds ratios (OR) and 95% confidence intervals (CI) ranging between 1.03 (95%CI: 1.01, 1.06) and 1.07 (95% CI: 1.04, 1.11) per 1-point difference in noise annoyance. Both noise annoyance and Lden showed independent associations with asthma symptoms among asthmatics, especially in those reporting adult-onset asthma [ORLden: 1.90 (95% CI: 1.25, 2.89) per 10 dB; p-value of interaction (adult-onset vs. childhood-onset): 0.03; ORnoise annoyance: 1.06 (95%CI: 0.97, 1.16) per 1-point difference; p-value of interaction: 0.06]. No associations were found with incident asthma. Transportation noise level and annoyance contributed to symptom exacerbation in adult asthma. This suggests both psychological and physiological noise reactions on the respiratory system, and could be relevant for asthma care. More studies are needed to better understand the effects of objective and perceived noise in asthma aetiology and overall respiratory health.
PMID: 30321849 [PubMed - as supplied by publisher]
Olopatadine/Mometasone Combination Nasal Spray Improves Seasonal Allergic Rhinitis Symptoms in an Environmental Exposure Chamber Study.
Ann Allergy Asthma Immunol. 2018 Oct 12;:
Authors: Patel P, Salapatek AM, Tantry SK
BACKGROUND: GSP301 nasal spray is a fixed-dose combination of the antihistamine olopatadine hydrochloride and the corticosteroid mometasone furoate intended for seasonal allergic rhinitis (SAR) treatment.
OBJECTIVE: Efficacy and safety of GSP301 once-daily (QD) or twice-daily (BID) were evaluated in a ragweed pollen Environmental Exposure Chamber (EEC).
METHODS: In this randomized, double-blind, double-dummy study, adults (18-65 years) with SAR were equally randomized to GSP301 BID (olopatadine 665μg/mometasone 25μg), GSP301 QD (olopatadine 665μg/mometasone 50μg), AzeFlu (FDA-approved azelastine 137μg/fluticasone 50μg BID), Olopatadine (FDA-approved formulation 665μg BID), or placebo (BID). During two visits (baseline and end of 14-day treatment), participants assessed SAR symptoms at specified time points. The primary endpoint-mean change from baseline in instantaneous Total Nasal Symptom Score (iTNSS) for GSP301 BID or QD versus placebo-was analyzed by ANCOVA. Onset of action, ocular symptoms, and adverse events (AEs) were assessed.
RESULTS: A total of 180 participants were randomized. Treatment with GSP301 BID or QD provided statistically significant improvements in Itnss versus placebo (least squares mean difference [95% CI] GSP301 BID: -3.60 [-4.89, -2.30]; QD: -3.05 [-4.35, -1.76]; P<0.0001, both). Significant improvements in iTNSS with GSP301 BID occurred by 10 minutes post-dose (- 1.26 [-2.30, -0.21], P=0.019) and were maintained at all later time points except one (2.5 hours). Treatment-emergent AEs occurred in 22.2%, 30.6%, 25.0%, 22.2%, and 16.7% of participants in GSP301 BID, GSP301 QD, AzeFlu, Olopatadine, and placebo groups, respectively.
CONCLUSION: In an EEC model, GSP301 BID and QD treatments were well tolerated and provided statistically significant and clinically meaningful SAR symptom improvement versus placebo.
PMID: 30321655 [PubMed - as supplied by publisher]
Severe Pertussis Infections in the United States, 2011-2015.
Clin Infect Dis. 2018 Oct 15;:
Authors: Mbayei SA, Faulkner A, Miner C, Edge K, Cruz V, Peña SA, Kudish K, Coleman J, Pradhan E, Thomas S, Martin S, Skoff TH
Background: The incidence of pertussis in the United States has increased in recent years. While characteristics of severe pertussis infection have been described in infants, fewer data are available in older children and adults. In this analysis, we characterize pertussis infections in hospitalized patients of all ages.
Methods: Cases of pertussis with cough onset from January 1, 2011 through December 31, 2015 from 7 U.S. Emerging Infections Program Network states were reviewed. Additional information on hospitalized patients was obtained through abstraction of the inpatient medical record. Descriptive and multivariable analyses were conducted to characterize severe pertussis infection and identify potential risk factors.
Results: Among 15,942 cases of pertussis reported, 515 (3.2%) were hospitalized. Three hospitalized patients died. Infants aged <2 months accounted for 1.6% of all pertussis cases but 29.3% of hospitalizations. Infants aged 2-11 months and adults aged ≥65 years also had high rates of hospitalization. Infants aged <2 months whose mothers received Tdap during the 3 rd trimester and children aged 2 months to 11 years who were up to date on pertussis-containing vaccines had a 43-66% reduced risk of hospitalization. Among adolescents aged 12-20 years, 43.5% had a history of asthma and among adults and ≥65 years, 26.8% had a history of chronic obstructive pulmonary disease.
Conclusions: Individuals at the extreme ends of life may be the most vulnerable to severe pertussis infections, though hospitalization was reported across all age groups. Continued monitoring of severe pertussis infections will be important to help guide prevention, control, and treatment options.
PMID: 30321305 [PubMed - as supplied by publisher]
The Impact of Chronic Diseases on the Quality of Life of Primary Care Patients in Cambodia, Myanmar and Vietnam.
Iran J Public Health. 2018 Sep;47(9):1308-1316
Authors: Pengpid S, Peltzer K
Background: Quality of life is a key measure in estimating the burden of disease, especially of chronic diseases. This study investigated the impact of a variety of chronic diseases on quality of life (QoL) in primary health care patients in three Southeast Asian countries (Cambodia, Myanmar, and Vietnam).
Methods: This cross-sectional survey was conducted on 4803 adult chronic disease patients (mean age 49.3 yr; SD=16.5) recruited systematically from primary health care centers in rural and urban areas in Cambodia, Myanmar and Vietnam in 2015.
Results: In ANCOVA analysis, adjusted for age, sex, marital status, geo locality, education, income and country, the poorest summative QoL was found among patients with cancer (49.8 mean score), followed by Parkinson's disease (50.7), mental disorder (53.2), epilepsy (53.3), asthma (54.3), kidney disease (54.3), chronic obstructive pulmonary disease (COPD) (54.5) and cardiovascular diseases (CVD) (55.1). Patients having three or more chronic conditions had a significantly lower summative QoL than patients with two chronic conditions (56.4) and one chronic condition (58.0). In multivariable linear regression analysis, younger age, being married or cohabitating, better education, living in an urban area, having only one chronic condition, not experiencing chronic disease stigma and good medication adherence was associated with better QoL in two or three of the study countries.
Conclusion: Major chronic diseases were found to have poor QoL. The determined QoL of chronic disease patients in this study provides information to improve the management of chronic diseases.
PMID: 30320005 [PubMed]
IgE-dependent sensitization in patients with COPD.
Ann Agric Environ Med. 2018 Sep 25;25(3):417-420
Authors: Bożek A, Rogala B
INTRODUCTION AND OBJECTIVE: The aim of the study was to evaluate the differences between asthma and COPD on the basis of the prevalence and profile of IgE-dependent sensitization to inhaled allergens, and the blood serum levels of select Th1/Th2 cytokines.
MATERIAL AND METHODS: 103 patients with COPD (114 patients with asthma and 121 controls) were included in the study. A skin prick test with common inhaled allergens was performed, and serum levels of IgE were measured in all subjects. Lymphocyte profiles were measured via the whole-blood method using fresh 10-ml blood samples treated with EDTA. The following surface antigens were measured: CD3, CD29, CD16, CD56, CD4, CD8, and HLA-DR. The Th1/Th2 profile in blood serum was determined using Th1/Th2 cytokine kits.
RESULTS: IgE-dependent sensitization to environmental allergens was found in 34 (33.3%) patients with COPD, 46 (40%) patients with asthma and in 14 (11.5%) volunteers. The odds ratio of sensitization in patients with COPD reached 0.89 (95% CI: 0.57-1.08) and it was more frequent than in the control population with an odds ratio of 0.71 (95% CI: 0.64-0.88). The serum concentration of IL-2 was significantly higher in patients with COPD and asthma than in controls. In the subgroup of patients with non-allergic asthma, similar serum concentrations were observed for all analyzed cytokines, except for IFN-gamma, which was lower in patients with COPD.
CONCLUSIONS: Both the prevalence and profile of IgE-dependent sensitization to inhaled allergens did not differ between asthma and COPD. Both Th2 and Th1 played a role in the immunopathology of asthma and COPD.
ABBREVIATIONS: COPD - Chronic Obstructive Pulmonary Disease; FEV1 - forced expiratory volume in one second; FVC - forced expiratory volume; GINA - Global Initiative for Asthma; GOLD - Global Initiative for Chronic Obstructive Lung Disease; MMRC - Modified Medical Research Council; Th1 - lymphocyte helper 1; Th2 - lymphocyte helper 2.
PMID: 30260198 [PubMed - indexed for MEDLINE]