Faculty of Medicine

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    Item type:Publication,
    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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    Item type:Publication,
    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.