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Frontiers in Pediatrics 2023Subcutaneous immunotherapy (SCIT) has been proved to be effective and safe in adult asthma. But it is still controversial in children. (Review)
Review
BACKGROUND
Subcutaneous immunotherapy (SCIT) has been proved to be effective and safe in adult asthma. But it is still controversial in children.
OBJECT
To evaluate the efficacy and safety of SCIT in asthmatic children with allergy to house dust mite.
METHOD
We searched the databases of Cochrane Library, EMBASE and MEDLINE (from 1 January 1990 to 1 December 2022). Two reviewers independently screened studies, extracted data and critically appraised the risk of bias. We used the Revman 5 to synthesize the effect sizes.
RESULTS
We finally selected 38 eligible studies including 21 randomized controlled trials to evaluate the efficacy and safety of SCIT and 17 observational studies to assess the safety. The results revealed that short-term asthma symptom scores were declined with a standardized mean difference (SMD) of -1.19 (95% CI: -1.87, -0.50) in 12 researches with high heterogeneity. Short-term asthma medication scores were decreased with SMD -1.04 (95% CI: -1.54, -0.54) in 12 heterogeneous researches. One study showed no significant reduction in combined symptom and medication scores without providing details. No studies we reviewed reported long-term efficacy. SCIT resulted in an obviously increased risk of adverse reactions compared with placebo. For secondary outcomes, SCIT improved life quality and reduced the numbers of annual asthma attacks and allergen-specific airway hyperreactivity, but without significant improvement in pulmonary function, asthma control or hospitalization.
CONCLUSIONS
SCIT can reduce the short-term symptom scores and medication scores regardless of different treatment duration or mono/polysensitization, but with an increased incidence of local and systemic adverse effects. Further studies on pediatric asthma are needed to evaluate the long-term efficacy, and clarify the effectiveness of SCIT in specific population using mix allergen extracts or with severe asthma. Overall, it is recommended for children with mild-moderate HDM-driven allergic asthma.
PubMed: 37397157
DOI: 10.3389/fped.2023.1137478 -
Clinical and Molecular Allergy : CMA 2016This meta-analysis compared the health-related quality of life (HRQL) of patients with allergic rhinitis (AR) and/or allergic asthma (AA) caused by perennial house dust... (Review)
Review
This meta-analysis compared the health-related quality of life (HRQL) of patients with allergic rhinitis (AR) and/or allergic asthma (AA) caused by perennial house dust mite (HDM) versus AR and/or AA caused by seasonal pollen allergy. Following a systematic search, the identified studies used the disease-specific rhinitis quality of life questionnaire or generic instruments (SF-36 and SF-12). Summary estimates obtained by meta-analysis showed that HRQL in patients with perennial HDM allergy was significantly worse than that of patients with seasonal pollen allergy, when measured by both disease-specific and generic HRQL instruments, and was reflected by an impact on both physical and mental health. A systematic review of cost data on AR and AA in selected European countries demonstrated that the majority of the economic burden was indirectly caused by high levels of absenteeism and presenteeism; there was little or no evidence of increasing or decreasing cost trends. Increased awareness of the detrimental effects of AR and/or AA on patients' HRQL and its considerable cost burden might encourage early diagnosis and treatment, in order to minimize the disease burden and ensure beneficial and cost-effective outcomes.
PubMed: 27708552
DOI: 10.1186/s12948-016-0049-9 -
Pediatric Allergy and Immunology :... Nov 2015Dust mite sensitization plays a controversial role in the development of atopic dermatitis. Despite a lack of evidence for its efficacy, dust mite avoidance is commonly... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Dust mite sensitization plays a controversial role in the development of atopic dermatitis. Despite a lack of evidence for its efficacy, dust mite avoidance is commonly recommended for the prevention and treatment of atopic dermatitis. We aimed to evaluate whether dust mite avoidance strategies reduce the risk of developing atopic dermatitis in high-risk infants compared to randomized controls.
METHODS
Studies were obtained by searching MEDLINE, PubMed, Scopus, The Cochrane Library, and The Global Resource of Eczema Trials databases. We included randomized, controlled trials of high-risk infants treated with a dust mite avoidance intervention and assessed for atopic dermatitis. Data were extracted independently by two reviewers using predefined criteria.
RESULTS
Seven randomized controlled trials met our inclusion criteria (total n = 3040). Studies were largely unblinded but otherwise of reasonable quality. Three trials utilizing a dust mite avoidance approach but not additional interventions were combined in a meta-analysis. Dust mite avoidance provided no benefit in the prevention of atopic dermatitis (relative risk (RR) = 1.08, 95% confidence interval (CI) = 0.78-1.49, I(2) = 73%).
CONCLUSIONS
Dust mite avoidance strategies alone or in combination with additional allergen avoidance modalities do not decrease the risk of developing atopic dermatitis and, given the current state of the evidence, should not be recommended for this purpose. The utility of dust mite avoidance for the treatment of atopic dermatitis or for the prevention and treatment of asthma or seasonal rhinoconjunctivitis are outside the scope of this review.
Topics: Allergens; Animals; Antigens, Dermatophagoides; Dermatitis, Atopic; Environmental Exposure; Humans; Models, Statistical; Primary Prevention; Pyroglyphidae; Treatment Outcome
PubMed: 26235650
DOI: 10.1111/pai.12452 -
Injury Prevention : Journal of the... Apr 2022Agriculture stands out in relation to the high number of occupational incidents and diseases. In this sense, grains postharvest operations, such as receiving,...
INTRODUCTION
Agriculture stands out in relation to the high number of occupational incidents and diseases. In this sense, grains postharvest operations, such as receiving, precleaning, drying, storage and shipping the grains, are highlighted in the number of injuries and fatalities.
AIM
To identify and extract qualitative and quantitative data related to the main occupational hazards present in grains postharvest operations at preprocessing and storage facilities.
METHODS
A systematic review was carried out in the databases of Science Direct, Scopus and Web of Science for papers published between 1980 and 2019. The abstract should have described a study related to any occupational hazard (physical, chemical, biological, ergonomic and mechanical) and at least one of the occupational hazards should be related to any postharvest operations.
RESULTS AND DISCUSSIONS
In total, 42% of 38 analysed papers were published between 2015 and 2019. Three journals were responsible for 45% of publications related to occupational hazards present in grains postharvest operations. The most part of analysed publications related to confined spaces, grain entrapment, machine entanglement and falls hazards are related to Purdue University's Agricultural Safety and Health Program which applied research in occupational safety at grains postharvest.
CONCLUSIONS
The creation of standardised internationals can collaborate to reduce occupational risks in grain storage units. It is suggested the development of monitoring technologies to obtain real-time information on noise, dust, gases and heat in postharvest operations and equipment. The use of intelligent algorithms can create prevention mechanisms for possible occupational risks and avoid injuries to employees.
Topics: Accidents, Occupational; Agriculture; Confined Spaces; Databases, Factual; Humans; Occupational Health
PubMed: 34656989
DOI: 10.1136/injuryprev-2021-044273 -
Occupational and Environmental Medicine Jan 2023Adverse occupational exposures can accelerate age-related lung function decline. Some longitudinal population-based studies have investigated this association. This... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Adverse occupational exposures can accelerate age-related lung function decline. Some longitudinal population-based studies have investigated this association. This study aims to examine this association using findings reported by longitudinal population-based studies.
METHODS
Ovid Medline, PubMed, Embase, and Web of Science were searched using keywords and text words related to occupational exposures and lung function and 12 longitudinal population-based studies were identified using predefined inclusion criteria. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Lung function decline was defined as annual loss of forced expiratory volume in 1 s (FEV), forced vital capacity (FVC) or the ratio (FEV/FVC). Fixed and random-effects meta-analyses were conducted to calculate pooled estimates for ever and cumulative exposures. Heterogeneity was assessed using the I test, and publication bias was evaluated using funnel plots.
RESULTS
Ever exposures to gases/fumes, vapours, gases, dusts, fumes (VGDF) and aromatic solvents were significantly associated with FEV decline in meta-analyses. Cumulative exposures for these three occupational agents observed a similar trend of FEV decline. Ever exposures to fungicides and cumulative exposures to biological dust, fungicides and insecticides were associated with FEV decline in fixed-effect models only. No statistically significant association was observed between mineral dust, herbicides and metals and FEV decline in meta-analyses.
CONCLUSION
Pooled estimates from the longitudinal population-based studies have provided evidence that occupational exposures are associated with FEV decline. Specific exposure control and respiratory health surveillance are required to protect the lung health of the workers.
Topics: Humans; Fungicides, Industrial; Occupational Exposure; Lung; Forced Expiratory Volume; Vital Capacity; Dust; Gases; Longitudinal Studies
PubMed: 36280382
DOI: 10.1136/oemed-2022-108237 -
PloS One 2023Occupational respiratory disorders are a major global public health concern among workers exposed to dust particles in dust-generating workplaces. Despite fragmented... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Occupational respiratory disorders are a major global public health concern among workers exposed to dust particles in dust-generating workplaces. Despite fragmented research findings on the magnitude of respiratory problems and the lack of a national occupational respiratory disease recording and reporting system at the Ethiopian factory, the prevalence of respiratory symptoms among factory workers were unknown. Therefore, the aim of this meta-analysis was to summarize and pool estimates from studies that reported the prevalence of respiratory symptoms and predictors among Ethiopian factory workers who worked in dusty environments.
METHODS
A systematic literature searches were conducted using electronic databases (PubMed, Science Direct, African Journals Online, and Web of Science). The primary and secondary outcomes were prevalence of respiratory symptoms and predictors, respectively. The STATA version 17 was used to analyze the data. A random effect meta-analysis model was used. Eggers test with p-value less than 5%, as well as the funnel plot, were used to assess publication bias.
RESULTS
The searches yielded 1596 articles, 15 of which were included in the systematic review and meta-analysis. The pooled prevalence of respiratory symptoms among Ethiopian factory workers was 54.96% [95% confidence interval (CI):49.33-60.59%]. Lack of occupational health and safety (OSH) training [Odds Ratio (OR) = 2.34, 95%CI:1.56-3.52], work experience of over 5 years [OR = 3.19, 95%CI: 1.33-7.65], not using personal protective equipment (PPE) [OR = 1.76, 95%CI:1.30-2.39], and working more than eight hours per day [OR = 1.89, 95%CI:1.16-3.05] were all significant predictors of respiratory symptoms.
CONCLUSION
The prevalence of respiratory symptom was found to be high in Ethiopian factory workers. To prevent workers from being exposed to dust, regular provision and monitoring of PPE use, workers OSH training, and adequate ventilation in the workplace should be implemented.
Topics: Humans; Dust; Occupational Exposure; Lung Diseases; Lung; Personal Protective Equipment; Occupational Diseases
PubMed: 37478114
DOI: 10.1371/journal.pone.0284551 -
International Journal of Environmental... Aug 2023Diet is the primary exposure pathway for phthalates, but relative contributions of other exposure sources are not well characterized. This study quantifies the relative... (Meta-Analysis)
Meta-Analysis Review
Characterizing the Contribution of Indoor Residential Phthalate and Phthalate Alternative Dust Concentrations to Internal Dose in the US General Population: An Updated Systematic Review and Meta-Analysis.
Diet is the primary exposure pathway for phthalates, but relative contributions of other exposure sources are not well characterized. This study quantifies the relative contribution of indoor residential dust phthalate and phthalate alternative concentrations to total internal dose estimated from the National Health and Nutrition Examination Survey (NHANES) urinary metabolite concentrations. Specifically, median phthalate and phthalate alternative concentrations measured in residential dust were determined by updating a pre-existing systematic review and meta-analysis published in 2015 and the attributable internal dose was estimated using intake and reverse dosimetry models. Employing a predetermined search strategy, 12 studies published between January 2000 and April 2022 from Web of Science and PubMed measuring phthalates and phthalate alternatives in residential dust were identified. From the data extracted, it was estimated that dust contributed more significantly to the internal dose of low-molecular weight chemicals such as DEP and BBP when compared to high-molecular weight chemicals such as DEHTP. Additionally, findings showed that the chemical profile of residential dust is changing temporally with more phthalate alternatives being detected in the indoor environment. Future studies should seek to characterize the contribution of dust to an overall phthalate and phthalate alternative intake for individuals who have higher than normal exposures.
Topics: Humans; Nutrition Surveys; Phthalic Acids; Dust; Molecular Weight; Thinness
PubMed: 37623174
DOI: 10.3390/ijerph20166589 -
International Archives of Occupational... Nov 2016To analyze overall and cause-specific mortality, especially from cancer, among cement production workers. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To analyze overall and cause-specific mortality, especially from cancer, among cement production workers.
INTRODUCTION
Results from some epidemiological studies suggested an increased risk of overall mortality and of stomach cancer associated with employment in the cement production, but the presence of a hazard and, if present, the magnitude of a risk have not been precisely quantified. We conducted a systematic review and meta-analysis of data on mortality from all causes, cardiovascular or respiratory diseases, and cancer among cement workers.
METHODS
The literature search in PubMed and Scopus up to February 2016 and with appropriate keywords on mortality among cement workers revealed 188 articles which were screened. A total of 117 articles were reviewed in full text and 12 articles, referring to 11 study populations, were found to be relevant and of sufficient quality for further analysis. Meta-analyses were performed using a random-effects model.
RESULTS
Eight cohort studies, one proportionate mortality study, and two case-control studies were identified. The summary RRs were 0.89 [95 % confidence interval (CI) 0.76-1.01] for all-cause mortality, 0.94 (95 %, CI 0.80-1.08) for cancer mortality, 1.07 (95 % CI 0.79-1.35) for lung cancer mortality, and 0.93 (95 % CI 0.70-1.17) for stomach cancer mortality, respectively. Significant heterogeneity in results was observed among studies.
CONCLUSION
The present meta-analysis does not provide evidence of increased risk of overall mortality, as well as cancer, cardiovascular or respiratory mortality in relation to employment in cement production.
Topics: Adult; Cardiovascular Diseases; Case-Control Studies; Cause of Death; Cohort Studies; Construction Industry; Construction Materials; Female; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasms; Occupational Diseases; Occupational Exposure; Respiratory Tract Diseases; Stomach Neoplasms
PubMed: 27604876
DOI: 10.1007/s00420-016-1167-x -
BMC Public Health May 2021While the association between occupational inhalation of silica dust and pulmonary tuberculosis has been known for over a century, there has never been a published... (Meta-Analysis)
Meta-Analysis
BACKGROUND
While the association between occupational inhalation of silica dust and pulmonary tuberculosis has been known for over a century, there has never been a published systematic review, particularly of experience in the current era of less severe silicosis and treatable tuberculosis. We undertook a systematic review of the evidence for the association between (1) silicosis and pulmonary tuberculosis, and (2) silica exposure and pulmonary tuberculosis controlling for silicosis, and their respective exposure-response gradients.
METHODS
We searched PUBMED and EMBASE, and selected studies according to a priori inclusion criteria. We extracted, summarised and pooled the results of published case-control and cohort studies of silica exposure and/or silicosis and incident active tuberculosis. Study quality was assessed on the Newcastle-Ottawa Scale. Where meta-analysis was possible, effect estimates were pooled using inverse-variance weighted random-effects models. Otherwise narrative and graphic synthesis was undertaken. Confidence regarding overall effect estimates was assessed using the GRADE schema.
RESULTS
Nine studies met the inclusion criteria. Meta-analysis of eight studies of silicosis and tuberculosis yielded a pooled relative risk of 4.01 (95% confidence interval (CI) 2.88, 5.58). Exposure-response gradients were strong with a low silicosis severity threshold for increased risk. Our GRADE assessment was high confidence in a strong association. Meta-analysis of five studies of silica exposure controlling for or excluding silicosis yielded a pooled relative risk of 1.92 (95% CI 1.36, 2.73). Exposure-response gradients were observable in individual studies but not finely stratified enough to infer an exposure threshold. Our GRADE assessment was low confidence in the estimated effect owing to inconsistency and use of proxies for silica exposure.
CONCLUSIONS
The evidence is robust for a strongly elevated risk of tuberculosis with radiological silicosis, with a low disease severity threshold. The effect estimate is more uncertain for silica exposure without radiological silicosis. Research is needed, particularly cohort studies measuring silica exposure in different settings, to characterise the effect more accurately as well as the silica exposure threshold that could be used to prevent excess tuberculosis risk.
Topics: Dust; Humans; Occupational Exposure; Risk Factors; Silicon Dioxide; Silicosis
PubMed: 34016067
DOI: 10.1186/s12889-021-10711-1 -
Occupational and Environmental Medicine Jul 2017Lung function is a predictor of morbidity and mortality, and the chronic nature of lung function decline allows for preventive initiatives. Proinflammatory constituents... (Meta-Analysis)
Meta-Analysis Review
Lung function is a predictor of morbidity and mortality, and the chronic nature of lung function decline allows for preventive initiatives. Proinflammatory constituents of organic dust are considered a possible cause of compromised respiratory health. The aim of this systematic review was to reveal the impact of organic dust exposure on long-term change in lung function. The literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Predefined criteria concerned study design: longitudinal, ≥1 year follow-up, ≥50 exposed; exposure measures: organic dust, measured or estimated, in different occupational settings; and outcome measures: change in lung function measured by spirometry. Based on these criteria, 1580 potentially relevant publications were narrowed down to 20 included publications. Quality was evaluated and discussed based on six objectively defined criteria. Overall, 14 studies found some type of association between exposure to organic dust and long-term change in lung function. However, the results were inconsistent and no specific work exposure showed more clear associations to change in lung function. Meta-analysis revealed an overall small significant excess loss in forced expiratory volume in the 1st s for exposed compared with controls of 4.92 mL/year (95% CI 0.14 to 9.69). No significant association was seen overall for forced vital capacity. 12 studies revealed a significant exposure-response relation between organic dust and change in lung function. The results were inconsistent across varying study design and different exposure measures and outcomes. We therefore conclude that there is limited evidence of a causal association between general exposure to organic dust and long-term excess decline in lung function.
Topics: Air Pollutants, Occupational; Dust; Endotoxins; Environmental Monitoring; Forced Expiratory Volume; Humans; Longitudinal Studies; Lung; Lung Diseases; Occupational Diseases; Occupational Exposure; Respiratory Function Tests; Spirometry
PubMed: 28404791
DOI: 10.1136/oemed-2016-103963