Few data exist on respiratory effects of indoor air quality and comfort parameters in the elderly. In the context of the GERIE study, we investigated for the first time the relationships of these factors to respiratory morbidity among elderly people permanently living in nursing homes in seven European countries. 600 elderly people from 50 nursing homes underwent a medical examination and completed a standardised questionnaire. Air quality and comfort parameters were objectively assessed in situ in the nursing home. Mean concentrations of air pollutants did not exceed the existing standards.Forced expiratory volume in 1 s/forced vital capacity ratio was highly significantly related to elevated levels of particles with a 50% cut-off aerodynamic diameter of <0.1 µm (PM0.1) (adjusted OR 8.16, 95% CI 2.24-29.3) and nitrogen dioxide (aOR 3.74, 95% CI 1.06-13.1). Excess risks for usual breathlessness and cough were found with elevated PM10 (aOR 1.53 (95% CI 1.15-2.07) and aOR 1.73 (95% CI 1.17-10.3), respectively) and nitrogen dioxide (aOR 1.58 (95% CI 1.15-2.20) and aOR 1.56 (95% CI 1.03-2.41), respectively). Excess risks for wheeze in the past year were found with PM0.1 (aOR 2.82, 95% CI 1.15-7.02) and for chronic obstructive pulmonary disease and exhaled carbon monoxide with formaldehyde (aOR 3.49 (95% CI 1.17-10.3) and aOR 1.25 (95% CI 1.02-1.55), respectively). Breathlessness and cough were associated with higher carbon dioxide. Relative humidity was inversely related to wheeze in the past year and usual cough. Elderly subjects aged ⩾80 years were at higher risk. Pollutant effects were more pronounced in the case of poor ventilation.Even at low levels, indoor air quality affected respiratory health in elderly people permanently living in nursing homes, with frailty increasing with age. The effects were modulated by ventilation.@ERSpublications Poor air quality in European nursing homes impairs respiratory health in the elderly permanently living in them
The findings indicate a more demanding psychosocial work environment exposure among symphony orchestra musicians than among Danish workers in general. Critical results are the relatively high work demands, low influence, and low social support, females being of higher risk than males.
ObjectiveTo identify risk factors (air pollution and family related) for the onset of asthma and persistent wheezing in children.DesignNationwide case-control study.SettingDenmark.ParticipantsAll Danish children born from 1997 to 2014 and followed for asthma onset and persistent wheezing from age 1 year to 15 years.Main outcome measureOnset of asthma and persistent wheezing.ResultsA higher incidence of asthma was found in children of parents with asthma (adjusted hazard ratio 2.29 (95% confidence interval 2.22 to 2.35) and mothers who smoked during pregnancy (1.20, 1.18 to 1.22), whereas a lower incidence was found in children of parents with high educational attainment (0.72, 0.69 to 0.75) and high incomes (0.85, 0.81 to 0.89). Exposure to particulate matter ≤2.5 µm (PM2.5) and ≤10 µm (PM10) and nitrate was associated with an increased risk of asthma and persistent wheezing, with hazard ratios per 5 µg/m3 increase in pollutant concentrations 1.05 (1.03 to 1.07) for PM2.5, 1.04 (1.02 to 1.06) for PM10, and 1.04 (1.03 to 1.04) for nitrogen dioxide. Only the positive association of PM2.5 with asthma and persistent wheezing remained robust across the different models and in sensitivity analyses.ConclusionsThe findings of this study suggest that children exposed to higher levels of PM2.5 are more likely to develop asthma and persistent wheezing than children who are not exposed. Other risk factors associated with these outcomes were parental asthma, parental education, and maternal smoking during pregnancy.
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