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Biological Potential and Exposure-Dose Relationships for Constituents of Cigarette Smoke
Published in Richard B. Gammage, Stephen V. Kaye, Vivian A. Jacobs, Indoor Air and Human Health, 2018
Joseph D. Brain, Brenda E. Barry
Most of this session will focus on characterizing and quantifying possible responses to the inhalation of passive cigarette smoke. However, it is essential to consider dose as well as response. Typically, for smokers, dose is given in terms of cigarettes smoked per day or cumulative pack years. For passive smoking, exposure may be characterized in terms of smoke concentration (ug/nr). But what do we really know about the total integrated dose to the respiratory tract resulting from passive smoking? What fraction is deposited and fails to exit with the expired air? Moreover, what is the fate of the deposited smoke? What is the anatomic distribution of the constituents of smoke that are retained? After briefly considering the chemical composition and toxic potential of tobacco smoke, we will describe the size and aerodynamic properties of smoke and relate it to the fraction of inspired smoke that deposits in the lungs. We will also consider where the smoke deposits and describe its possible fate.
Pulmonary complications of illicit drug use
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
In a case series reported by Johnson and colleagues, four patients who smoked marijuana had large bullous lesions in a paraseptal distribution in the upper lung zones. The average smoking history of these patients was 26-pack years.38 Goldstein and colleagues compared two groups of patients with bullous pulmonary damage and intravenous drug abuse; both groups were smokers. The drug users had large bullous lesions confined exclusively to the upper lobes while the non-users had bullae that varied in size, were generally diffuse and were rarely limited to the upper lobes.37 Both groups of patients had reduced diffusing capacity for carbon monoxide (DLCO), mild hypoxia and moderately severe to severe obstruction on pulmonary function tests;39 in contrast, patients who inject methylphenidate tablets have bibasilar disease similar to that seen in α1 antitrypsin deficiency.40 Though experimental and clinical evidence is lacking, recurrent foreign body emboli leading to the formation of thin-walled cavities which coalesce to form larger bullous lesions causing airflow obstruction are thought to be the cause of these lesions.39
Computer-Aided Diagnosis of Chronic Obstructive Pulmonary Disease Using Accurate Lung Air Volume Estimation in Computed Tomographic Imaging
Published in Ayman El-Baz, Jasjit S. Suri, Lung Imaging and CADx, 2019
Hadi Moghadas-Dastjerdi, Mohammad Reza Ahmadzadeh, Abbas Samani
The inclusion criteria in this study were adult subjects, 45–80 years of age, with a diagnosis of COPD or at least a 10-pack-year smoking history. Each pack-year is equal to smoking one pack (or 20) of cigarettes per day for 1 year or, similarly, smoking two packs per day for 6 months. Moreover, subjects who were unable to undergo CT imaging (e.g., pregnant women and subjects who had a history of thoracic surgery or thorax radiotherapy) were excluded. Exclusion criteria also included subjects suffering from concurrent respiratory disorders in addition to COPD in their medical records. All the subjects were provided with a comprehensive explanation of the study and its objectives before their oral and written consents were obtained.
World Trade Center Health Program best practices for diagnosing and treating chronic obstructive pulmonary disease
Published in Archives of Environmental & Occupational Health, 2023
James E. Cone, Rafael E. de la Hoz
Once the diagnosis is established based on good quality post-bronchodilator spirometry, the evaluation is completed with a classification of airflow limitation severity based on post-bronchodilator FEV1 (grades I–IV), and of symptoms and exacerbation risk (groups A-D), and an assessment of comorbidities (details provided in the GOLD guideline). In diagnosing occupational COPD, it is particularly important to elicit a history of exposure to inhaled particulates, fumes, dusts, gases and/or vapors in the longest held occupation. Generally, the more intense and/or a longer exposure would favor a diagnosis of COPD, particularly in a non- or very light smoker (eg, 10 pack-years). Finally, it is very important to assess and grade impairment and/or disability, using accepted and applicable guidelines, and render appropriate public health and occupational surveillance reporting.
The World Trade Center Health Program: Cancer screening and cancer care best practices
Published in Archives of Environmental & Occupational Health, 2023
Geoffrey M. Calvert, Gerald Lilly, John Cochran
The USPSTF recognizes the need to increase lung cancer screening (in the US in 2018, screening rates were ∼5%24). It recommends that patients be assessed for lung cancer risk based on age and pack-year smoking history.12 If the patient is aged 50 to 80 years and has a 20 pack-year or more smoking history, and currently smokes or quit within the past 15 years, the patient should be engaged in shared decision-making about lung cancer screening. Screening should be offered to eligible persons who express a preference for it. In addition, evidence-based tobacco cessation treatment is recommended for current smokers. These recommendations can be found at this link: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening.
Knowledge of and attitude toward venous thromboembolism among professional drivers in Saudi Arabia
Published in Archives of Environmental & Occupational Health, 2022
Adnan Raed Alnaser, Abdullah Abdulaziz Abdulwahab Khojah, Ammar S. A. Hashemi, Bandar Alsabban, Ammar Y. E. Musa, Eltayeb A. Albasheer, Tawfik Mamoun Rajab, Mohamed A. Ali, Juliann Saquib, Abdulrahman Almazrou, Nazmus Saquib
The questionnaire included demographic, work-related, and chronic disease items, including the following: (1) age (in years), country of origin, education level, marital status, physical activity, sexual activity, smoking status, and intensity and duration of smoking (2) years of driving, driving hours/day, and vehicle types, and (3) self-reported presence of chronic diseases (for example, diabetes, hypertension, and cancer). Pack-year was calculated by multiplying intensity of smoking (pack per day) with duration (years of smoking).