СВЯЗЬ КУРЕНИЯ И РАБОТЫ В УСЛОВИЯХ ВЫСОКОГОРЬЯ с РАЗВИТИЕМ ОБСТРУКТИВНЫХ НАРУШЕНИЙ ВЕНТИЛЯЦИИ
Abstract
The aim of this study was to detect if smoking and work at high altitude was associated with obstructive ventilation defect (OVD). 1484 workers (1292 males, 192 females), aged 18-61 years (mean age 38.0 ± 9.3), working at high altitude mining company in Kyrgyzstan, were screened for lung function. Spirometry was performed to compare people with different smoking duration and working shiftrotations at altitude 4,000 m (N=1140) with those working full-day at middle-altitude (N=64) and never working at high altitude (N=280). Though bronchial obstruction was similarly prevalent in patients working at high and low altitude and 8.4% was the mean prevalence of (FEV|/FVC < 70%), flows of high altitude workers except for peak expiratory flow (PEF) was less, and work at high altitude was associated with OVD - OR 1.53. Smoking had a greater association with OVD, and it doubled the OVD probability. To conclude, though lung function of people working shift rotations at high altitude was similar to people not exposed to it, smoking was the most meaning factor to cause bronchial obstruction, whereas high altitude emerged to be less harmful.
Keywords:
spirometry, high altitude, smokingReferences
1. Bousquet J., Dahl R., Khaltaev N. Global Alliance against Chronic Respiratory Diseases. Eur Respir J 2007; 29: 233-239.
2. Cote T. R , Stroup D. F., Dwyer D. М. и др. Chronic obstructive pulmonary disease mortality. A role for altitude. Chest 1993; 103: 1194-1197.
3. National Tobacco Information Online System (NATIONS). http://data.euro, who. int/tobacco/?TabID=2404.
4. Hultgren H. High Altitude Medicine. Stanford, USA: Hultgren Publications; 1997.
5. Luks A. М., Swenson E. R. Travel to high altitude with pre-existing lung disease. Eur Resp J 2007; 29: 770- 792.
6. Powel F. L., Garcia N. Physiological effects of intermittent hypoxia. High Alt Med Biol 2000; 1:125-136.
7. Katayama K., Sato Y., Ishida К. и др. The effects of intermittent exposure to hypoxia during endurance exercise training on the ventilatory responses to hypoxia and hypercapnia in humans. Eur J Appl Physiol Occup Physiol 1998; 78:189-194.
Nanduri R , Prabhakar Ю те D. Ventilatory changes during intermittent hypoxia: importance o f pattern and duration. High Alt Med Biol 2002; 3:195-204.
9. Cogo A., Fischer R , Schoene R. Respiratory diseases and high altitude. High Alt Med Biol 2004; 5:435-444.
10. Rodriguez-Rousin R., MacNee W. Pathophysiology of chronic obstructive pulmonary disease. В кн.: Management of Chronic Obstructive Pulmonary Disease. Brussels: ERS Journals Ltd; 2006.
11. World Health Organization. Guidelines for controlling and monitoring the tobacco epidemic. Geneva: WHO;1998,
12. American Thoracic Society, Standardization of Spirometry, 1994 Update. Am J Respir Crit Care Med 1995; 152:1107-1136.
13. Halbert R J., Natoli J. L., Gano А. и др. Global burden of COPD: systematic review and meta-analysis. Eur Respir J 2006; 28: 523-532.
14. Zielinski J., Bednarek M. Early detection of COPD in a high-risk population using spirometric screening. Chest 2001;119:731-736.
15. Finkelstein S., Tomashefski J. F., Shillito F. H. Pulmonary mechanics at altitude in normal and obstructive lung disease patients. Aerosp Med 1965; 36: 880-884.
16. Koskela H. O., Koskela A. K., Tukiaineu H. O. Bronchoconstriction due to cold weather in COPD. The roles o f direct airway effects and cutaneous reflex mechanisms. Chest 1996; 110: 632-636.
17. Rahn H., Hammond D. Vital capacity at reduced barometric pressure. J Appl Physiol 1951; 4: 715-724.
18. Tenney S. М., Rahn H., Stound R. С. и др. Adaptation to high altitude. Changing in lung volumes during the first seven days at Mt Evansm Colorado. J Appl Physiol 1953; 5: 607-613.
19. Droma Т., McCullough R., McCullough RE., и др. Increased vital and total lung capacities in Tibetian compared to Han residents in Lhasa (3,658 m). Am J Phys Anthropology 1991; 86: 341-351.
20. Cogo A., Legnani D., Allegra L. Respiratory function at different altitudes. Respiration 1997; 64: 416-421.