Bronchitis epidemiology

Epidemiological studies of nickel-producing and nickel-using workers seldom indicate excess mortaUty from nonmalignant respiratory disease. Evidence for such effects exists mainly as a few reports of isolated incidents of asthma, pulmonary fibrosis, chronic bronchitis, and emphysema in nickel workers. Nickel may or may not play a causal role in these incidents (131). 

Limited epidemiological data suggest that chronic human inhalation exposure to kerosene vapor and/or kerosene combustion products from cooking with kerosene stoves does not induce asthmatic respiratory effects. The presence of kerosene stoves in the homes of Malaysian children was not associated with chronic cough, persistent wheeze, asthma, or chest illness (Azizi and Henry 1991). Asthmatic bronchitis and frequent common colds in 3-year-old Japanese children were not associated with the presence of kerosene stoves in their homes (Tominaga and Itoh 1985). The latter study corrected for exposure to passive smoke. These data are of limited usefulness because the duration of exposure was not reported and the levels of kerosene exposure could not be quantified. Finally, it cannot be determined whether actual exposure to kerosene occurred in these individuals because kerosene exposure was assumed to occur if kerosene was used during cooking or if a kerosene stove was present in the home. 

Sulfur mustards (designated H [mustard], HD [distilled mustard], and HT [HD and T mixture]) do not present acute lethal hazards. Their principal effect is severe blistering of the skin and mucous membranes. Epidemiological evidence indicates a causal relationship between exposure to mustard agent at high concentrations and the development of chronic nonreversible respiratory disorders, such as chronic bronchitis and asthma, and ocular diseases, such as delayed recurrent keratitis and prolonged, intractable conjunctivitis (IOM, 1993). Sulfur mustard has been classified as a known human carcinogen based on evidence of in-... 

TCDD can produce respiratory irritation, but the findings from controlled epidemiologic studies do not support an association between 2,3,7,8-TCDD exposure and chronic respiratory disease. It should be noted, however, that chronic bronchitis and related effects were observed in many Yusho and Yu-Cheng patients, who were exposed to the structurally related CDFs (ATSDR 1994). 

Ball P. Epidemiology and treatment of chronic bronchitis and its exacerbations. Chest 1995 108 438-52. 

Of the British soldiers exposed to mustard in World War I, 12% were awarded disability compensation for respiratory disorders that were believed to be due to mustard exposures during combat.106 Bronchitis was the major complaint emphysema and asthma were also reported. However, epidemiological studies of the relationship between agent... 

Evidence has grown over the last decade, that urban airborne particles at ambient concentration levels common in many cities in Europe, America and Asia exert adverse effects on human health. Short- or long-term exposure to particulate matter (measured as PMio or PM2.5) is associated with an increase risk of cardiovascular and respiratory morbidity and mortality. Collectively the toxicological and epidemiological studies provide sufficient evidence that a causal relationship is likely to exist between exposure to ambient concentrations of PMjo or PM2.5 and specific human morbidity (exacerbation of chronic bronchitis, asthma or coronary heart disease) and premature deaths. 

In epidemiological studies, short-term exposures to sulfur dioxide that lasted a day or so have been correlated with deaths, although there was concomitant exposure to high particulate levels during these pollution episodes. Long-term or chronic exposures to levels of up to 50 ppb of sulfur dioxide-induced respiratory symptoms and disease (coughs and bronchitis), especially in young children and smokers. 

Occupational exposures to inhaled carbon black have been reported to cause bronchitis, pneumoconiosis, and emphysema however, this information is sketchy and derived more from case reports than from adequate epidemiologieal studies of morbidity (26). Epidemiological studies of workers suggest that heavy, prolonged exposures can cause reduced lung function, but there is little evidenee of debilitating pneumoconiosis from contemporary exposures (72). 

Medical Research Council. Definition and classification of chronic bronchitis for clinical and epidemiological purposes. Lancet 1965 1 775-781. 

Dockery DW, Damokosh AI, Neas LM, Raizenne M, Spengler JD, Koutrakis P, Ware JH, Speizer FE. Health effects of acid aerosols on North American children respiratory symptoms and illness. Environ Health Perspect 1996 104 500-505. Holland WW, Reid DD. The urban factor in chronic bronchitis. Lancet 1965 1 445. Chestnut LG, Schwartz J, Savitz DA, Burchflel CM. Pulmonary function and ambient particulate matter epidemiological evidence from NHANES I. Arch Environ Health 1991 46 135-144. 

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