Faculty of Medicine

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    CHRONIC RESPIRATORY SYMPTOMS AND SPIROMETRIC PARAMETERS AMONG PROFESSIONAL DRIVERS - THE IMPACT OF OCCUPATIONAL EXPOSURE AND WORK TENURE
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2026-06-18)
    Andonov, Goran
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    Aim. To assess the prevalence of chronic respiratory symptoms, spirometric parameters and the effects of occupational exposure among professional drivers. Material and methods. A cross-sectional epidemiological study was conducted including 70 male professional drivers and 70 administrative staff matched by age, work tenure, occupational exposure and smoking status. Data on respiratory symptoms, smoking status, occupational exposure to harmful agents and work tenure were collected using a standardized questionnaire. Spirometry was performed to assess lung function. Results. Professional drivers had a significantly higher prevalence of respiratory symptoms compared to controls, including any respiratory symptom (81.4% vs. 58.6%, p=0.003), nasal symptoms (35.7% vs. 8.6%, p<0.001), cough (61.4% vs 34.3%, p=0.002), cough with phlegm (37.1% vs. 20.0%, p=0.040), dyspnea (31.4% vs. 17.1%, p=0.049) and wheezing (25.7% vs. 7.1%, p=0.006). All spirometric parameters were significantly lower in drivers, indicating involvement of both large and small airways (p<0.05). Drivers with ≥ 20 years of work tenure exhibited a significantly higher prevalence of symptoms and lower spirometric values. Multivariable logistic regression identified exposure to gases as the strongest independent predictor of respiratory symptoms (adjusted OR up to 12.4, p<0.01), followed by exposure to smoke (adjusted OR up to 6.31, p<0.05). Dust exposure showed a non-significant trend, while vapors were not associated with respiratory symptoms. Conclusion. Professional drivers are at increased risk of developing respiratory symptoms and lung function impairment compared to the control group. Occupational exposure to gases and smoke represents the main independent risk factor, while longer work tenure suggests a cumulative adverse effect.
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    PREVALENCE AND CHARACTERISTICS OF CHRONIC RESPIRATORY SYMPTOMS AND LUNG FUNCTION AMONG VINEYARD WORKERS
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2025-12-16)
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    Atanasovska, Aneta
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    Bislimovska, Dragana
    Aim: To determine the frequency of chronic respiratory symptoms and ventilatory function in a group of vineyard workers. Results: Most of the vineyard workers believe that they are sufficiently informed about the health risks related to their work activities and the necessary measures needed for health protection. Also, most of them use the mandatory personal protective equipment, while almost all workers during their work, to a greater or lesser extent, were exposed to occupational respiratory hazards: dust, smoke, fumes, gases and pesticides. About 45% of subjects had one or more respiratory symptoms, and the most common symptoms were cough (40%), cough with phlegm (31.1%), as well as dyspnea and wheezing (22.2%). The frequency of chronic respiratory symptoms was higher in workers with more than 15 years of exposure, with a statistically significant difference in frequency of cough, cough with phlegm, and dyspnea. The risk of respiratory symptoms was about 3 times higher in active smokers and about 2 times higher in vineyard workers with exposure duration longer than 15 years. The mean values of all spirometric parameters were within the reference values, while lung function impairment of obstructive, restrictive and combined pattern was registered in about 20% of them. The mean values of spirometric parameters in vineyard workers with exposure duration longer than 15 years were lower than those with less than 15 years of experience, with a significant difference for small airways flow indices. Conclusion: The obtained results indicate the need to improve preventive measures.</jats:p>
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    BODY COMPOSITION AND RESPIRATORY PARAMETER ANALYSIS AT FOOTBALL PLAYERS
    (ANTHROPOLOGICAL SOCIETY OF SERBIA, 2023-09-27)
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    Pulmonary function tests (PFTs) are commonly used for evaluating respiratory status and managing persons with known pulmonary disease. They have become part of routine health examinations in respiratory, occupational, and sports medicine, and in public-health screening. The results of PFTs are interpreted in relation to normal range reference values, as recommended by the guidelines of the American Thoracic Society (ATS) and the European Community forCoal and Steel (ECCS). Spirometry is a gold standard pulmonary function test that measureshow an individual inhales or exhales volumes of air as a function of time. It is the mostimportant and most frequently performed pulmonary function testing procedure, having becomeindispensable for the prevention, diagnosis, and evaluation of various respiratory impairments. Anumber of 61 football players were divided into 2 groups according to their age, 13 (13.85 ± 3.26) and27 years (23.82 ± 3.32). This study was organized by the Institute of Medical, Experimentaland Applied Physiology and Anthropology, Medical faculty – UKIM, Skopje. The spirometry method was performed with the Spirobank II spirometer (Rome, Italy), for the followingparameters: forced vital capacity (FVC), forced expiratory volume in the first second (FEV1),and the ratio FEV1/FVC ratio.Body composition analyzer InBody 720, Great Britain, was usedto determine body weight (kg), body height (cm), body mass index - BMI weight (kg / m 2 ),skeletal muscle mass SMM (kg) and the amount of proteins (kg) and minerals (kg). We did notfind any statistically significant differences for forced vital capacity (FVC), forced expiratoryvolume in the first second (FEV1), and the ratio FEV1/FVC ratio.
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    COPD IN A SAMPLE OF GENERAL ADULT POPULATION FROM THE SKOPJE REGION
    (University Ss. Cyril and Methodius in Skopje, 2022)
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    Atanasovska, Aneta
    Introduction. Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity, disability and mortality in the last decades worldwide. Aim of the study. To determine the COPD prevalence in a sample of general adult population from the Skopje region and its distribution by sex, age, smoking status, working status, family history of chronic bronchitis/asthma, and mode of household heating and cooking. Methods. A cross-sectional study (prevalence study) including 2,348 participants (1,239 males and 1,109 females, aged 18 to 86 years) from the Skopje region was performed at the Institute for Occupational Health of RN Macedonia, Skopje, in the period 2018-2021. The study protocol included completion of a questionnaire and spirometric measurements (pre and post-bronchodilator spirometry). COPD was defined by spirometric finding of persistent airflow limitation in symptomatic study subjects. Results. COPD prevalence in the whole study sample was 4.6%, being non-significantly higher in men (5.1%) than in women (4.1%). Fourfold higher prevalence of COPD was registered in the study subjects aged over 45 years as compared to the younger ones (6.7% vs. 1.6%; P = 0.000). COPD prevalence was significantly higher in active smokers as compared to non-smoking study subjects (9.4% vs. 1.9%; P = 0.000). In regard to working status, COPD prevalence among active workers was 3.9%, in the group of retired persons 8.7%, while in the group of students there was not a single subject with COPD. In addition, COPD prevalence in the workers occupationally exposed to noxious particles or gases was significantly higher than in unexposed workers (4.7% vs. 2.4%; P = 0.021). There was no statistically significant difference in the COPD prevalence between study subjects with positive and negative family history of asthma/chronic bronchitis (4.8% vs. 4.5%), as well as between study subjects who used biomass fuels for heating and cooking (6.2%) and those who did not use traditional fuels for household needs (4.0%). Conclusion. Our findings have indicated the age, active smoking and occupational exposures to noxious particles or gases as the factors significantly related to COPD prevalence in the examined sample of general adult population from the Skopje region.
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    Lung Function Impairment in Construction Workers – Influence of Smoking and Exposure Duration
    (Scientific Foundation SPIROSKI, 2021-05-08)
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    Bislimovska, Dragana
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    Atanasovska, Aneta
    AIM: The objective of the study was to assess the influence of exposure duration and smoking on ventilatory impairment among construction workers. METHODS: A cross-sectional study was performed, including 83 construction workers aged 18–64 years, compared to equivalent number of office controls matched by age, workplace exposure duration, and smoking status. Data on chronic respiratory symptoms, work history, and smoking status were collected by standardized questionnaire, while lung functional testing of the examined subjects was performed by spirometry. RESULTS: Mean values of spirometric parameters were lower in construction workers compared to controls with statistical significance registered for maximal expiratory flow (MEF25), MEF50, and MEF75. Lung functions of construction workers have been found to decrease in relation to exposure duration but reached significance only for small airways changes. There was a significant difference in detected ventilatory impairment between exposed workers and controls for any type of ventilatory impairment, as well as obstructive and combined ventilatory pattern and obstructive ventilatory pattern in small airways. Obstructive ventilatory impairment was significantly associated with life-time smoking in construction workers, while obstructive ventilatory pattern in small airways was significantly associated with life-time smoking. The combined effect of daily smoking, life-time smoking, and number of cigarettes smoked daily was shown to have a significant influence in their development. The risk for obstructive ventilatory pattern in small airways among exposed subjects was about 4 fold higher in those exposed more than 20 years (odds ratio [OR] = 3.68 [1.01–14.59] confidence interval [CI] 95%), and about 2.5 fold higher in smokers (OR = 2.57 [0.92-7.25] CI 95%). Exposure duration, smoking and age had independent effect only on small airways changes and force expiratory volume in the 1st s/force vital capacity %. CONCLUSION: Our data suggest the importance of the joint effect of job exposure in construction and daily smoking on the development of lung function impairment and airflow limitation, being dominant, especially on small airways.