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  1. Article ; Online: The value of periodic spirometry for early recognition of long-term excessive lung function decline in individuals.

    Hnizdo, Eva

    Journal of occupational and environmental medicine

    2012  Volume 54, Issue 12, Page(s) 1506–1512

    Abstract: Objective: To establish the value of workplace spirometry monitoring methods for early recognition of long-term excessive lung function decline in individuals.: Methods: Sensitivity, specificity, and positive likelihood ratio were calculated to ... ...

    Abstract Objective: To establish the value of workplace spirometry monitoring methods for early recognition of long-term excessive lung function decline in individuals.
    Methods: Sensitivity, specificity, and positive likelihood ratio were calculated to determine the predictive value of the linear regression slope and limits of longitudinal decline for early prediction of long-term excessive forced expiratory volume in 1 second (FEV1) decline (> 90 mL/yr established over 9 to 11 years) in ongoing spirometry monitoring programs (firefighters and construction workers) and a historical program (paper-pulp mill workers). The longitudinal limits account for the expected FEV1 within-person variability.
    Results: The longitudinal limits achieved clinical "usefulness" (positive likelihood ratio 10 or higher) from the fourth to fifth year of follow-up, whereas the linear regression slope was less useful. The usefulness depended on data precision and measurement frequency.
    Conclusion: The limits of longitudinal decline are more useful for early recognition of long-term excessive FEV1 decline than the linear regression slope.
    MeSH term(s) Adult ; Construction Industry ; Disease Progression ; Firefighters ; Follow-Up Studies ; Forced Expiratory Volume ; Humans ; Linear Models ; Male ; Middle Aged ; Occupational Diseases/diagnosis ; Occupational Diseases/physiopathology ; Occupational Health Services/methods ; Predictive Value of Tests ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/physiopathology ; Sensitivity and Specificity ; Spirometry
    Language English
    Publishing date 2012-12
    Publishing country United States
    Document type Evaluation Studies ; Journal Article ; Research Support, N.I.H., Intramural
    ZDB-ID 1223932-x
    ISSN 1536-5948 ; 1076-2752
    ISSN (online) 1536-5948
    ISSN 1076-2752
    DOI 10.1097/JOM.0b013e3182664811
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Lung function loss associated with occupational dust exposure in metal smelting.

    Hnizdo, Eva

    American journal of respiratory and critical care medicine

    2010  Volume 181, Issue 11, Page(s) 1162–1163

    MeSH term(s) Dust ; Forced Expiratory Volume ; Humans ; Metallurgy ; Occupational Diseases/chemically induced ; Occupational Diseases/prevention & control ; Occupational Exposure/adverse effects ; Pulmonary Disease, Chronic Obstructive/chemically induced ; Pulmonary Disease, Chronic Obstructive/prevention & control ; Spirometry
    Chemical Substances Dust
    Language English
    Publishing date 2010-06-01
    Publishing country United States
    Document type Comment ; Editorial
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.201002-0306ED
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Change in prevalence of restrictive lung impairment in the U.S. population and associated risk factors: the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 2007-2010.

    Kurth, Laura / Hnizdo, Eva

    Multidisciplinary respiratory medicine

    2015  Volume 10, Issue 1, Page(s) 7

    Abstract: ... a population increase in the proportion of comorbidities associated with restrictive pattern (i.e. diabetes and ...

    Abstract Background: Data for the U.S adult population from the National Health and Nutrition Examination Survey (NHANES) were used to evaluate risk factors for a restrictive pattern on spirometry and estimate the change in its prevalence from the 1988-1994 to 2007-2010 sampling periods. Several previous epidemiologic studies used the Global Initiative for Chronic Obstructive Lung Disease fixed forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) > 0.70 criteria for classifying restrictive pattern rather than the age-defined American Thoracic Society (ATS)/European Respiratory Society (ERS) lower limit of normal (LLN) criteria, which may lead to misclassification.
    Methods: Spirometry measurements from NHANES data for the 1988-1994 and 2007-2010 periods were analyzed to estimate the age-standardized prevalence of a restrictive pattern on spirometry and the change in prevalence over time for adults aged 20-79. A restrictive pattern was defined based on ATS/ERS LLN criteria as FEV1/FVC > LLN and FVC < LLN, and a moderate to more severe restrictive pattern was further evaluated using FEV1 < 70% predicted. The associations between demographic and other individual risk factors for restrictive lung impairment were examined using multivariable logistic regression models for the two consecutive time periods.
    Results: The overall age-standardized prevalence of restrictive pattern decreased significantly from 7.2% (1988-1994) to 5.4% (2007-2010) (p = 0.0013). The prevalence of moderate to more severe restrictive pattern also decreased significantly from 2.0% to 1.4% (p = 0.023). Factors positively associated with restrictive pattern on spirometry included age, female sex, white race, lower education, former and current smoking, and comorbidities including doctor-diagnosed cardiovascular disease, doctor-diagnosed diabetes, and abdominal obesity.
    Conclusions: The overall prevalence of restrictive pattern and moderate to more severe restrictive pattern decreased between the 1988-1994 and 2007-2010 survey periods despite a population increase in the proportion of comorbidities associated with restrictive pattern (i.e. diabetes and abdominal obesity). This suggests a decline in individual risk factors for restrictive pattern and a need for future research.
    Language English
    Publishing date 2015-02-28
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2677839-7
    ISSN 2049-6958 ; 1828-695X
    ISSN (online) 2049-6958
    ISSN 1828-695X
    DOI 10.1186/s40248-015-0003-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Fixed FEV(1)/FVC ratio <0.7 for identifying airflow limitation: not a good idea in occupational settings.

    Hnizdo, Eva / Petsonk, Edward L

    Occupational and environmental medicine

    2012  Volume 69, Issue 3, Page(s) 227

    MeSH term(s) Air Pollutants, Occupational/adverse effects ; Humans ; Male ; Metallurgy ; Occupational Diseases/epidemiology ; Pulmonary Disease, Chronic Obstructive/epidemiology
    Chemical Substances Air Pollutants, Occupational
    Language English
    Publishing date 2012-03
    Publishing country England
    Document type Comment ; Letter ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 1180733-7
    ISSN 1470-7926 ; 1351-0711
    ISSN (online) 1470-7926
    ISSN 1351-0711
    DOI 10.1136/oemed-2011-100365
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Changes in prevalence of chronic obstructive pulmonary disease and asthma in the US population and associated risk factors.

    Halldin, Cara N / Doney, Brent C / Hnizdo, Eva

    Chronic respiratory disease

    2014  Volume 12, Issue 1, Page(s) 47–60

    Abstract: ... in prevalence of self-reported doctor-diagnosed COPD (i.e. chronic bronchitis and emphysema) and asthma and ...

    Abstract Chronic lower airway diseases, including chronic obstructive pulmonary disease (COPD) and asthma, are currently the third leading cause of death in the United States. We aimed to evaluate changes in prevalence of and risk factors for COPD and asthma among the US adult population. We evaluated changes in prevalence of self-reported doctor-diagnosed COPD (i.e. chronic bronchitis and emphysema) and asthma and self-reported respiratory symptoms comparing data from the 1988-1994 and 2007-2010 National Health and Nutrition Examination Surveys. To investigate changes in the severity of each outcome over the two periods, we calculated changes in the proportions of spirometry-based airflow obstruction for each outcome. Prevalence of doctor-diagnosed chronic bronchitis and emphysema decreased significantly mainly among males, while asthma increased only among females. The self-reported disease and the respiratory symptoms were associated with increased prevalence of airflow obstruction for both periods. However, the prevalence of airflow obstruction decreased significantly in the second period among those with shortness of breath and doctor-diagnosed respiratory conditions (chronic bronchitis, emphysema, and asthma). COPD outcomes and asthma were associated with lower education, smoking, underweight and obesity, and occupational dusts and fumes exposure. Chronic lower airway diseases continue to be major public health problems. However, decreased prevalence of doctor-diagnosed chronic bronchitis and emphysema (in males) and decreased prevalence of airflow obstruction in those with respiratory symptoms and doctor-diagnosed respiratory diseases may indicate a declining trend and decrease in disease severity between the two periods. Continued focus on prevention of these diseases through public health interventions is prudent.
    MeSH term(s) Adult ; Aged ; Asthma/epidemiology ; Asthma/physiopathology ; Asthma, Occupational/epidemiology ; Asthma, Occupational/physiopathology ; Cross-Sectional Studies ; Dyspnea/epidemiology ; Female ; Humans ; Male ; Middle Aged ; Nutrition Surveys ; Obesity/epidemiology ; Occupational Diseases/epidemiology ; Occupational Diseases/physiopathology ; Occupational Exposure/statistics & numerical data ; Prevalence ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Pulmonary Disease, Chronic Obstructive/physiopathology ; Respiratory Function Tests ; Respiratory Sounds ; Risk Factors ; Severity of Illness Index ; Sex Distribution ; Smoking/epidemiology ; United States/epidemiology
    Language English
    Publishing date 2014-12-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 2211488-9
    ISSN 1479-9731 ; 1479-9723
    ISSN (online) 1479-9731
    ISSN 1479-9723
    DOI 10.1177/1479972314562409
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Occupational exposure to gases, fumes, or chemicals and risk of community-acquired pneumonia.

    Hnizdo, Eva / Storey, Eileen

    American journal of respiratory and critical care medicine

    2010  Volume 182, Issue 8, Page(s) 1087–8; author reply 1088

    MeSH term(s) Aged ; Air Pollutants, Occupational/adverse effects ; Canada/epidemiology ; Community-Acquired Infections ; Disease Susceptibility ; Humans ; Metallurgy ; Pneumonia/epidemiology ; Pneumonia/etiology
    Chemical Substances Air Pollutants, Occupational
    Language English
    Publishing date 2010-10-15
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/ajrccm.182.8.1087
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Total and Cause-Specific Mortality Risk Associated With Low-Level Exposure to Crystalline Silica: A 44-Year Cohort Study From China.

    Liu, Yuewei / Zhou, Yun / Hnizdo, Eva / Shi, Tingming / Steenland, Kyle / He, Xinjian / Chen, Weihong

    American journal of epidemiology

    2017  Volume 186, Issue 4, Page(s) 481–490

    Abstract: The association between low-level crystalline silica (silica) exposure and mortality risk is not well understood. We investigated a cohort of 44,807 Chinese workers who had worked in metal mines or pottery factories for at least 1 year from January 1, ... ...

    Abstract The association between low-level crystalline silica (silica) exposure and mortality risk is not well understood. We investigated a cohort of 44,807 Chinese workers who had worked in metal mines or pottery factories for at least 1 year from January 1, 1960, to December 31, 1974, and were followed through 2003. Low-level silica exposure was defined as having a lifetime highest annual mean silica exposure at or under a permissible exposure limit (PEL). We considered 3 widely used PELs, including 0.05 mg/m3, 0.10 mg/m3, and 0.35 mg/m3. Cumulative silica exposure was estimated by linking a job exposure matrix with each participant's work history. For the 0.10-mg/m3 exposure level, Cox proportional hazards models showed significantly increased risk of mortality from all diseases (for each 1-ln mg/m3-years increase in logged cumulative silica exposure, hazard ratio (HR) = 1.05, 95% confidence interval (CI): 1.03, 1.07), malignant neoplasms (HR = 1.06, 95% CI: 1.03, 1.09), lung cancer (HR = 1.08, 95% CI: 1.02, 1.14), ischemic heart disease (HR = 1.09, 95% CI: 1.02, 1.16), pulmonary heart disease (HR = 1.08, 95% CI: 1.00, 1.16), and respiratory disease (HR = 1.20, 95% CI: 1.14, 1.26). The 0.05-mg/m3 and 0.35-mg/m3 exposure levels yielded similar associations. Long-term exposure to low levels (PELs ≤0.05 mg/m3, ≤0.10 mg/m3, or ≤0.35 mg/m3) of silica is associated with increased total and certain cause-specific mortality risk. Control of ambient silica levels and use of personal protective equipment should be emphasized in practice.
    MeSH term(s) Agriculture/statistics & numerical data ; Cause of Death ; China/epidemiology ; Female ; Heart Diseases/chemically induced ; Heart Diseases/mortality ; Humans ; Longitudinal Studies ; Male ; Manufacturing Industry/statistics & numerical data ; Mining/statistics & numerical data ; Neoplasms/chemically induced ; Neoplasms/mortality ; Occupational Diseases/chemically induced ; Occupational Diseases/mortality ; Occupational Exposure/adverse effects ; Proportional Hazards Models ; Respiration Disorders/chemically induced ; Respiration Disorders/mortality ; Silicon Dioxide/adverse effects
    Chemical Substances Silicon Dioxide (7631-86-9)
    Language English
    Publishing date 2017-08-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2937-3
    ISSN 1476-6256 ; 0002-9262
    ISSN (online) 1476-6256
    ISSN 0002-9262
    DOI 10.1093/aje/kwx124
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Workplace spirometry monitoring for respiratory disease prevention: a methods review.

    Hnizdo, E / Glindmeyer, H W / Petsonk, E L

    The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease

    2010  Volume 14, Issue 7, Page(s) 796–805

    Abstract: This report reviews methods applicable in workplace spirometry monitoring for the identification of individuals with excessive lung function decline. Specific issues addressed include 1) maintaining longitudinal spirometry data precision at an acceptable ...

    Abstract This report reviews methods applicable in workplace spirometry monitoring for the identification of individuals with excessive lung function decline. Specific issues addressed include 1) maintaining longitudinal spirometry data precision at an acceptable level so that declines due to adverse physiological processes in the lung can be readily detected in an individual; 2) applying interpretative strategies that have a high likelihood of identifying workers at risk of developing lung function impairment; and 3) enhancing effectiveness of spirometry monitoring for intervention and disease prevention. Applications in ongoing computerized spirometry monitoring programs are described that demonstrate approaches to improving spirometry data precision and quality, and facilitating informed decision-making on disease prevention.
    MeSH term(s) Decision Making ; Diagnosis, Computer-Assisted/methods ; Humans ; Lung Diseases/diagnosis ; Lung Diseases/prevention & control ; Mass Screening/methods ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/prevention & control ; Respiratory Function Tests ; Spirometry/methods ; Spirometry/standards ; Workplace
    Language English
    Publishing date 2010-07
    Publishing country France
    Document type Journal Article ; Review
    ZDB-ID 1385624-8
    ISSN 1815-7920 ; 1027-3719
    ISSN (online) 1815-7920
    ISSN 1027-3719
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Health risks among white South African goldminers--dust, smoking and chronic obstructive pulmonary disease.

    Hnizdo, E

    South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde

    1992  Volume 81, Issue 10, Page(s) 512–517

    Abstract: The South African goldmining industry employs a large labour force exposed to several health hazards, of which one of the most important is underground dust, containing a high level of free crystalline silica (30%). Inhalation of silica dust can cause ... ...

    Abstract The South African goldmining industry employs a large labour force exposed to several health hazards, of which one of the most important is underground dust, containing a high level of free crystalline silica (30%). Inhalation of silica dust can cause chronic obstructive pulmonary disease (COPD). The present paper reviews the epidemiological evidence on COPD in white South African goldminers. COPD emerges as a major cause of disability and increased mortality. The associated risk factors are smoking and combined exposure to dust and smoking. In conclusion, decreased tobacco consumption in white goldminers would in most cases prevent serious lung function impairment and the premature deaths associated with it.
    MeSH term(s) Dust/adverse effects ; Gold ; Health Status Indicators ; Humans ; Lung/physiopathology ; Lung Diseases, Obstructive/epidemiology ; Lung Diseases, Obstructive/mortality ; Lung Diseases, Obstructive/physiopathology ; Male ; Mining ; Occupational Diseases/epidemiology ; Occupational Diseases/mortality ; Occupational Diseases/physiopathology ; Risk Factors ; Smoking/adverse effects ; South Africa
    Chemical Substances Dust ; Gold (7440-57-5)
    Language English
    Publishing date 1992-05-16
    Publishing country South Africa
    Document type Journal Article
    ZDB-ID 390968-2
    ISSN 2078-5135 ; 0256-9574 ; 0038-2469
    ISSN (online) 2078-5135
    ISSN 0256-9574 ; 0038-2469
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Loss of lung function associated with exposure to silica dust and with smoking and its relation to disability and mortality in South African gold miners.

    Hnizdo, E

    British journal of industrial medicine

    1992  Volume 49, Issue 7, Page(s) 472–479

    Abstract: The data from a lung function study on 2209 white 45-54 year old South African gold miners in 1968-71 and at a five year follow up examination, were analysed to establish the actual loss of lung function associated with exposure to silica dust and with ... ...

    Abstract The data from a lung function study on 2209 white 45-54 year old South African gold miners in 1968-71 and at a five year follow up examination, were analysed to establish the actual loss of lung function associated with exposure to silica dust and with smoking. Ex-smokers were excluded from the analysis. Of the remaining 1625 subjects, 1249 had the five year follow up test of lung function. The estimated excess loss of lung function for a 50 year old gold miner, associated with 24 years of underground dust exposure of an average respirable dust concentration of 0.30 mg m-3 (14.4 ghm-3) was 236 ml of FEV1 (95% confidence interval (95% CI 134-337) and 217 ml of FVC (95% CI 110-324). By comparison, the effect of smoking one packet of cigarettes a day over 30 years was associated with an estimated loss of 552 ml of FEV1 (95% CI 461-644) and 335 ml of FVC (95% CI 170-500). The cumulative dust exposure was not associated with the longitudinal loss of FEV1 or FVC when the initial FEV1 and FVC were adjusted in the models. According to the predicted values, however, gold miners appear to have a greater loss of lung function from 50 to 55 years of age than that predicted for a general population.
    MeSH term(s) Aged ; Dust/adverse effects ; Forced Expiratory Volume ; Gold ; Humans ; Lung/physiopathology ; Middle Aged ; Mining ; Silicon Dioxide/adverse effects ; Silicosis/mortality ; Silicosis/physiopathology ; Smoking/mortality ; Smoking/physiopathology ; Vital Capacity
    Chemical Substances Dust ; Gold (7440-57-5) ; Silicon Dioxide (7631-86-9)
    Language English
    Publishing date 1992-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 280395-1
    ISSN 0007-1072
    ISSN 0007-1072
    DOI 10.1136/oem.49.7.472
    Database MEDical Literature Analysis and Retrieval System OnLINE

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