BACKGROUND: Chronic exposure to air pollutants harms human health, and at a geographical level, concentrations of air pollutants are often associated with socioeconomic disadvantage.
OBJECTIVE: The aim of this study was to investigate the effects of educational attainment and air pollution on lung function in older adults, and whether air pollution may mediate the effect of education.
METHODS: The study included 6381 individuals (mean age 58.24 ± 7.14 years) who participated in the Czech HAPPIE (Health, Alcohol, and Psychosocial Factors in Eastern Europe) study. Participants\' residential addresses were linked to air pollution data, including mean exposures to PM10 (particulate matter of aerodynamic diameter below 10 μm) and NO2 (nitrogen dioxide). We used path analysis to link educational attainment and air pollutants to a standardized measure of the Forced Expiratory Volume in the first second (FEV1).
RESULTS: Higher levels of participants\' education were associated with lower exposures to PM10 and NO2. Individuals with tertiary education had higher standardized FEV1 than individuals with primary education (88 % vs 95 %). Path analysis revealed a direct positive effect of education on FEV1, while about 12 % of the relationship between education and lung function was mediated by PM10 and NO2. CONCLUSIONS: Education (typically completed at young ages) appeared to have a protective effect on lung function later in life, and a small part of this effect was mediated by air pollution.

UNASSIGNED: Despite deep cultural traditions, incense burning significantly impacts respiratory health. Effects of Arabian bakhour remain unknown in Saudi Arabia\'s Jazan region with prevalent use. This cross-sectional study addresses this gap by investigating bakhour exposure and respiratory diseases.
UNASSIGNED: This was descriptive cross-sectional study conducted in Jazan area, Saudi Arabia, from October 2023 to March 2024. A total of 1612 participants age more than 18 years, both gender and resident of Jazan Area were included. Those aged less than 18 years were excluded. SPSS v 26 was used for data analysis.
UNASSIGNED: The sample (n=1612) had a mean age of 29±11 years and was 63% female. Bakhour use was nearly universal (98%), especially using coal (73%). Higher bakhour frequency significantly associated with increased cough (p<0.01) and dyspnea (p<0.01). Certain bakhour types linked to greater allergic rhinitis prevalence (p<0.01). Regression analysis revealed cough during bakhour use worsened respiratory health (increased respiratory score) by 3.89 times (95% CI 1.13-6.64; p=0.006) while dyspnea increased the score by 7.48 times (95% CI 4.70-10.25; p<0.001).
UNASSIGNED: This study provides valuable insights into the association between Bakhour use and respiratory health in the Jazan region. The findings emphasize the need for further research and public health interventions to mitigate potential respiratory risks associated with Bakhour use.

Background Population aging is a global phenomenon associated with declines in muscle mass, physical activity levels, and respiratory health among elderly individuals. Despite evidence suggesting the benefits of physical activity on respiratory function, there is limited research examining its effects on lung function in the Indian elderly population. Materials and methods This cross-sectional study aimed to investigate the impact of different intensities of physical activity on respiratory health parameters among apparently healthy elderly males aged 60-80 years. Participants were categorized into walking, swimming, and sedentary groups based on their level of physical activity. Anthropometric measurements, cardiovascular parameters, respiratory endurance tests, and spirometry were conducted to assess lung function. Statistical analysis included nonparametric tests to compare the groups. Results Age, height, weight, BMI, waist circumference, and hip circumference were similar across groups, but the waist-to-hip ratio was higher in the sedentary group. Systolic and diastolic blood pressure did not differ significantly, while the pulse rate was lower in the swimming group. The sedentary group exhibited lower respiratory endurance, with a significantly reduced 40 mmHg endurance test and maximum expiratory pressure compared to the walking and swimming groups. Spirometry results showed significant improvements in various parameters, including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak expiratory flow rate (PEFR), forced expiratory flow 25% (FEF-25), and maximum voluntary ventilation (MVV) in the walking and swimming groups compared to the sedentary group. Conclusion Regular physical activity, particularly walking and swimming, appears to positively influence respiratory health parameters among elderly males. Engaging in these activities may enhance respiratory muscle strength and lung function, potentially mitigating age-related declines in pulmonary function and promoting overall well-being.

BACKGROUND: Exposure to gases and particulate matter released during volcanic eruptions can prove harmful to population health. This paper reports the preliminary results of the ASHES study, aimed at ascertaining the respiratory health effects of the 2021 volcanic eruption in La Palma Island (Spain) on the adult population without previous respiratory disease.
METHODS: Ambispective cohort study on the healthy adult population. Three exposure groups were considered: Group 1, high exposure; Group 2, moderate exposure; and Group 3, minor or no exposure. We carried out a descriptive analysis of symptoms during and after the eruption, as well as measure lung function after the eruption (through forced spirometry and diffusing capacity of carbon monoxide).
RESULTS: The analysis included 474 subjects: 54 in Group 1, 335 in Group 2, and 85 in Group 3. A significant increase in most symptoms was observed for subjects in the groups exposed during the eruption. After the eruption, this increase remained for some symptoms. There seems to be a dose-response relationship, such that the higher the exposure, the higher the odds ratio. A prebronchodilator FEV1/FVC ratio<70% was observed in 13.0% of subjects in Group 1, 8.6% of subjects in Group 2, and 7.1% of subjects in Group 3.
CONCLUSIONS: This study is the first to report a dose-response relationship between exposure to volcanic eruptions and the presence of symptoms in adults. Furthermore, there is a tendency toward obstructive impairment in individuals with higher exposure.

In 2014, a fire at an open cut coalmine in regional Victoria, Australia burned for 6 weeks. Residents of the nearby town of Morwell were exposed to smoke, which included high levels of fine particulate matter (PM2.5). We investigated whether the long-term effects of PM2.5 on respiratory health were moderated by diet quality. A cross-sectional analysis was conducted of data collected 8.5 years after the mine fire from 282 residents of Morwell and 166 residents from the nearby unexposed town of Sale. Primary outcomes were respiratory symptoms. Exposure was coalmine fire-related PM2.5 and diet quality was assessed as Australian Recommended Food Score (ARFS) derived using the Australian Eating Survey (AES). The moderating effect of diet quality on respiratory outcomes associated with PM2.5 was assessed using logistic regression models, adjusting for potential confounders. Diet quality was poor in this sample, with 60% in the lowest category of overall diet quality. Overall diet quality and fruit and vegetable quality significantly attenuated the association between PM2.5 and prevalence of chronic cough and phlegm. Sauce/condiment intake was associated with a greater effect of PM2.5 on COPD prevalence. No other moderating effects were significant. The moderating effects of overall diet quality and vegetable and fruit intake aligned with a priori hypotheses, suggesting potential protective benefits. While more evidence is needed to confirm these findings, improving diets, especially fruit and vegetable intake, may provide some protection against the effects of smoke exposure from fire events.

This study aimed to investigate whether physical activity (PA) is associated with a lower risk of subsequently developing chronic obstructive pulmonary disease (COPD).
We conducted this population-based longitudinal follow-up study in a community in Taiwan. This study recruited 61,446 subjects who had participated in the Keelung Community-based Integrated Screening Program (KCIS) between 2005 and 2012. During their participation in KCIS, they were provided with structured questionnaires to collect their baseline characteristics, including weekly PA time. After excluding subjects diagnosed with COPD before they joined KCIS and/or who provided incomplete lifestyle data, 59,457 subjects remained, and were classified into three groups based on their weekly PA time: i.e., as NPA (no regular PA), LPA (low PA, <90 min/week) and HPA (high PA, ≥90 min/week). The primary outcome was a new diagnosis of COPD, followed up until the end of 2015 or their death. Cox proportional-hazard regression was used to assess the impact of PA on the risk of COPD.
The risk of COPD was more than 20% lower in the LPA and HPA groups than in the NPA group. Specifically, the adjusted hazard ratio for the risk of COPD was 0.72 in the LPA group (95% CI, 0.61-0.85, p < 0.001) and 0.79 in the HPA group (95% CI, 0.69-0.90, p < 0.001).
Our research uncovered an inverse relationship between PA and COPD. The findings suggest that PA might be useful as a strategy for the primary prevention of COPD.

Cleaning product use has been associated with adverse respiratory health effects such as asthma in cleaning staff and healthcare workers. Research in health effects from cleaning products has largely depended upon collecting exposure information by questionnaires which has limitations such as recall bias and underestimation of exposure. The aim of this study was to develop a Cleaning and Hazardous Products Exposure Logging (CHaPEL) app with a barcode scanner and to test the feasibility of this app with university cleaners.
The CHaPEL app was developed to collect information on demographics, individual product information, and exposure information. It also included an ease-of-use survey. A pilot study with university cleaning workers was undertaken in which cleaning workers scanned each product after use and answered the survey. Respiratory hazards of cleaning substances in the scanned cleaning products were screened by safety data sheets, a Quantitative Structure-Activity Relationship model and an asthmagen list established by an expert group in the US.
Eighteen university cleaners participated in this study over a period of 5 weeks. In total, 77 survey responses and 6 cleaning products were collected and all reported that using the app was easy. The most frequently used product was a multi-surface cleaner followed by a disinfectant. Out of 14 substances in cleaning products, ethanolamine and Alkyl (C12-16) dimethyl benzyl ammonium chloride were found as respiratory hazardous substances.
The CHaPEL app is a user-friendly immediate way to successfully collect exposure information using the barcodes of cleaning products. This tool could be useful for future epidemiological studies focused on exposure assessment with less interruption to the workers.

UNASSIGNED: Chronic lung-related diseases, with asthma being the most prominent example, characterized by diverse symptoms and triggers, present significant challenges in disease management and prediction of exacerbations across patients. This research aimed to devise a practical solution by introducing a personalized alert system tailored to individual lung function and environmental conditions, offering a holistic approach for the management of a range of chronic respiratory conditions.
UNASSIGNED: In response to these challenges, we developed a personalized alert system based on individual lung function tests conducted in diverse environmental conditions, as determined by air-quality sensors. Our research was substantiated through an observational pilot study involving twelve healthy participants. These participants were exposed to varying air quality, temperature, and humidity conditions, and their lung function, as indicated by peak expiratory flow (PEF) values, was monitored.
UNASSIGNED: The study revealed pronounced variability in pulmonary responses across different environments. Leveraging these findings, we proposed a design of a personalized alarm system that monitors air quality in real-time and issues alerts under potentially unfavorable environmental conditions. Additionally, we investigated the use of basic machine learning techniques to predict PEF values in these varied environmental settings.
UNASSIGNED: The proposed system offers a proactive approach for individuals, particularly those with asthma, to actively manage their respiratory health. By providing real-time monitoring and personalized alerts, it aims to minimize exposure to potential asthma triggers. Ultimately, our system seeks to empower individuals with the tools for timely intervention, potentially reducing discomfort and enhancing management of asthma symptoms.

It is appreciated that digital health is increasing in interest as an important area for efficiently standardizing and developing health services in Ireland, and worldwide. However, digital health is still considered to be in its infancy and there is a need to understand important factors that will support the development and uniform uptake of these technologies, which embrace their utility and ensure data trustworthiness. This constituted the first study to identify themes believed to be relevant by respiratory care and digital health experts in the Republic of Ireland to help inform future decision-making among respiratory patients that may potentially facilitate engagement with and appropriate use of digital health innovation (DHI). The study explored and identified expert participant perceptions, beliefs, barriers, and cues to action that would inform content and future deployment of living labs in respiratory care for remote patient monitoring of people with respiratory diseases using DHI. The objective of this case study was to generate and evaluate appropriate data sets to inform the selection and future deployment of an ICT-enabling technology that will empower patients to manage their respiratory systems in real-time in a safe effective manner through remote consultation with health service providers. The co-creation of effective DHI for respiratory care will be informed by multi-actor stakeholder participation, such as through a Quintuple Helix Hub framework combining university-industry-government-healthcare-society engagements. Studies, such as this, will help bridge the interface between top-down digital health policies and bottom-up end-user engagements to ensure safe and effective use of health technology. In addition, it will address the need to reach a consensus on appropriate key performance indicators (KPIs) for effective uptake, implementation, standardization, and regulation of DHI.

Data regarding the association of sarcopenia with chronic lung disease (CLD) has led to inconclusive results. The main goal of this research was to investigate the association between sarcopenia and CLD in middle-aged and elderly individuals in China.
The study sample consisted of 11,077 individuals without CLD at baseline chosen from the China Health and Retirement Longitudinal Study (CHARLS) data from 2015, followed up until 2018. Sarcopenia was identified utilizing the criteria set by the Asian Working Group on Sarcopenia (AWGS 2019) in 2019. Individuals were categorized into no-sarcopenia, possible-sarcopenia, and sarcopenia groups. The outcome of the study was considered to be incident CLD, which included chronic bronchitis, emphysema, pulmonary heart disease, and asthma. The association between sarcopenia and the risk of CLD was also examined by employing weighted Cox proportional hazard regression models.
A total of 356 (3.20 %) participants developed CLD during the 3.6-year follow-up period. The cumulative incidence of CLD in the no-sarcopenia, possible-sarcopenia, and sarcopenia groups was 2.80 % (230/8222), 4.37 % (55/1260), and 4.45 % (71/1595), respectively. Individuals with possible sarcopenia {hazard ratio [HR] [95 % confidence interval (CI)]: 1.48 [1.04-2.09]} and sarcopenia [HR (95 % CI): 1.68 (1.12-2.51)] demonstrated a considerably high risk of developing CLD compared to individuals in the no-sarcopenia group. Moreover, individuals diagnosed with sarcopenia, as per the criteria established by the European Working Group on Sarcopenia in Older People (EWGSOP) 2018, were at considerably high risk for developing CLD compared to those in the no-sarcopenia group.
This research involving adult Chinese individuals demonstrated a significant association between, possible sarcopenia and sarcopenia with an elevated risk of incident CLD, thereby emphasizing the importance of monitoring respiratory health in this population.
Question: Whether muscle mass and sarcopenia are associated with the development of chronic lung disease (CLD) in Asian middle-aged and elderly individuals.
This longitudinal study encompassing 11,077 adults aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS) data with 3.6 years of follow-up revealed a positive association between sarcopenia at baseline and incidence of CLD. Meaning: The findings suggest that possible sarcopenia and sarcopenia are linked to the development of CLD. Consequently, middle-aged and elderly individuals with possible sarcopenia and sarcopenia can be considered vulnerable regarding the primary prevention strategies for CLD.