Percorrer por autor "Mahesh, Padukudru Anand"
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- Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) studyPublication . Ratanachina, Jate; Amaral, Andre F.S.; De Matteis, Sara; Lawin, Herve; Mortimer, Kevin; Obaseki, Daniel O.; Harrabi, Imed; Denguezli, Meriam; Wouters, Emiel F.M.; Janson, Christer; Nielsen, Rune; Gulsvik, Amund; Cherkaski, Hamid Hacene; Mejza, Filip; Mahesh, Padukudru Anand; Elsony, Asma; Ahmed, Rana; Tan, Wan; Loh, Li Cher; Rashid, Abdul; Studnicka, Michael; Nafees, Asaad A.; Seemungal, Terence; Aquart-Stewart, Althea; Al Ghobain, Mohammed; Zheng, Jinping; Juvekar, Sanjay; Salvi, Sundeep; Jogi, Rain; Mannino, David; Gislason, Thorarinn; Buist, A. Sonia; Cullinan, Paul; Burney, Peter; BOLD Collaborative Research Group; Dias, Hermínia BritesBackground: Chronic obstructive pulmonary disease has been associated with exposure in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study. Methods: We analysed cross-sectional data from 28 823 adults (≥40 years) in 34 countries. We considered 11 occupations and grouped them by likelihood of exposure to organic dust, inorganic dust, and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, forced vital capacity (FVC), and forced expiratory volume in 1 s (FEV1)/FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income. Results: Overall, working in settings with potentially high exposure to dust or fumes was associated with respiratory symptoms but not lung function differences. The most common occupation was farming. Compared to people not working in any of the 11 considered occupations, those who were farmers for ≥20 years were more likely to have a chronic cough (OR 1.52, 95% CI 1.19-1.94), wheeze (OR 1.37, 95% CI 1.16-1.63) and dyspnoea (OR 1.83, 95% CI 1.53-2.20), but not lower FVC (β=0.02 L, 95% CI -0.02-0.06 L) or lower FEV1/FVC (β=0.04%, 95% CI -0.49-0.58%). Some findings differed by sex and gross national income. Conclusion: At a population level, the occupational exposures considered in this study do not appear to be major determinants of differences in lung function, although they are associated with more respiratory symptoms. Because not all work settings were included in this study, respiratory surveillance should still be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.
- Chronic airflow obstruction and ambient particulate air pollutionPublication . Amaral, Andre F.; Burney, Peter G.; Patel, Jaymini; Minelli, Cosetta; Mejza, Filip; Mannino, David M.; Seemungal, Terence A.; Mahesh, Padukudru Anand; Lo, Li Cher; Janson, Christer; Juvekar, Sanjay; Denguezli, Meriam; Harrabi, Imed; Wouters, Emiel F.; Cherkaski, Hamid; Mortimer, Kevin; Jogi, Rain; Bateman, Eric D.; Fuertes, Elaine; Al Ghobain, Mohammed; Tan, Wan; Obaseki, Daniel O.; El Sony, Asma; Studnicka, Michael; Aquart-Stewart, Althea; Koul, Parvaiz; Lawin, Herve; Nafees, Asaad Ahmed; Awopeju, Olayemi; Erhabor, Gregory E.; Gislason, Thorarinn; Welte, Tobias; Gulsvik, Amund; Nielsen, Rune; Gnatiuc, Louisa; Kocabas, Ali; Marks, Guy B.; Sooronbaev, Talant; Mbatchou Ngahane, Bertrand Hugo; Barbara, Cristina; Buist, A. Sonia; BOLD Collaborative Research Group; Dias, Hermínia BritesSmoking is the most well-established cause of chronic airflow obstruction (CAO) but particulate air pollution and poverty have also been implicated. We regressed the sex-specific prevalence of CAO from 41 Burden of Obstructive Lung Disease study sites against smoking prevalence from the same study, the gross national income per capita, and the local annual mean level of ambient particulate matter (PM2.5) using negative binomial regression. The prevalence of CAO was not independently associated with PM2.5 but was strongly associated with smoking and was also associated with poverty. Strengthening tobacco control and improving understanding of the link between CAO and poverty should be prioritized.
- Concordance between FVC and FEV6 for identifying chronic airflow obstruction and spirometric restriction in the Burden of Obstructive Lung Disease (BOLD) studyPublication . Knox-Brown, Ben; Potts, James; Franssen, Frits M. E.; Nielsen, Rune; Denguezli, Meriem; Rotevatn, Anders Ørskov; Juvekar, Sanjay K.; Cherkaski, Hamid Hacene; Studnicka, Michael; Sylvester, Karl Peter; Mortimer, Kevin; Bateman, Eric D.; Janson, Christer; Malinovschi, Andrei; Seemungal, Terence; Koul, Parvaiz; Mannino, David; Mahesh, Padukudru Anand; Jogi, Rain; Mejza, Filip; Al Ghobain, Mohammed; Paraguas, Stefanni Nonna M.; Welte, Tobias; Wouters, Eliel; Gislason, Thorarinn; Harrabi, Imed; Dias, Maria Hermínia Monteiro Brites; Obaseki, Daniel O.; Kocabas, Ali; Barbara, Cristina; Cardoso, João; Agarwal, Dhiraj; Nafees, Asaad Ahmed; Rodrigues, Fatima; Garcia-Larsen, Vanessa; Erhabor, Gregory E.; Loh, Li-Cher; Amaral, Andre F. S.Introduction: We investigated whether the forced expiratory volume in 6 s (FEV6) can be used as a surrogate for the forced vital capacity (FVC). Methods: The Burden of Obstructive Lung Disease is a multinational cohort study. At baseline, data were collected from adults aged 40 years or older, from 41 sites across 34 countries. Participants from 18 sites were followed up after a median of 8.3 years. Participants who completed the study core questionnaire and had acceptable post-bronchodilator spirometry were included. We performed receiver operating characteristic analyses to measure the ability of FEV1/FEV6 less than the lower limit of normal (LLN) to correctly classify FEV1/FVC less than the LLN, and FEV6 less than the LLN to correctly classify FVC less than the LLN. We used multilevel regression analyses to assess the association of discordant measurements with respiratory symptoms, quality of life, and lung function decline. Results: At baseline, 28,604 participants were included. 53% were female (15,060). 10% (2876) had chronic airflow obstruction for FEV1/FVC, compared with 9% (2704) for FEV1/FEV6. 37% (10,637) had spirometric restriction for FVC, compared with 35% (9978) for FEV6. The FEV1/FEV6 had excellent accuracy in identifying FEV1/FVC less than the LLN (area under the curve (AUC): 0.90, 95% CI, 0.89 to 0.91, κ coefficient 0.82). The FEV6 also had excellent agreement in identifying FVC less than the LLN (AUC: 0.95, 95% CI, 0.94 to 0.95, κ coefficient 0.90). Discordant reductions in FEV1/FEV6 (1%, 345) and FEV6 (1%, 309) were associated with greater odds of having respiratory symptoms and a lower physical quality of life. 3870 participants were followed up with. Those with discordant reductions in FEV1/FEV6 and FEV6 were more likely to have chronic airflow obstruction and spirometric restriction at follow-up. Conclusions: There is strong agreement between the FVC and FEV6 in the identification of chronic airflow obstruction and spirometric restriction.