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Background The altered respiratory patterns have a significant impact on our health. However, the links between respiration patterns during spontaneous breathing and physical fitness remain unknown. Therefore, we sought to examine how the respiratory pattern during spontaneous breathing interacts with physical fitness. Methods A total of 610 participants (aged 20-59 years) were enrolled; 163 men (age = 41 ± 11) and 401 women (age = 42 ± 9) were included for analysis. The parameters of the respiration pattern were respiration rate (RR) and inhalation/exhalation (I/E) ratio. The physical fitness components were body size, visuomotor reaction time, balance, flexibility, hand grip strength, back extension strength, vertical jump height, number of push-ups, number of sit-ups, and the maximum rate of oxygen consumption. The data were analyzed separately for two gender groups. Participants within each gender group were further divided into two age categories (young: 20−39 years, middle-aged: 40−59 years) for the analysis, and both correlational and comparative tests were used to solidify the results. Results Neither RRs nor the I/E ratios were substantially correlated with physical fitness in women. In addition, the I/E ratios showed no significant correlation with physical fitness in young men, while the results from correlational and comparative tests were inconsistent in middle-aged men. Consistently, men with lower RRs exhibited significantly shorter visuomotor reaction times in two age groups, and demonstrated significantly higher vertical jump heights in the middle-aged group. Conclusions In women, respiratory patterns were not correlated with physical fitness. The relationship between middle-aged men’s I/E ratios and their physical fitness warrants further investigation. Men with lower RRs may have better visual-motor coordination and/or sustained attention, while middle-aged men with lower RRs may also have greater leg explosive power and neuromuscular coordination, which should be considered for physical assessment and health improvement.

Oxygen therapy prolongs survival in patients with severe hypoxemia but is a burden. In this trial, therapy for 24 rather than 15 hours per day did not reduce the risk of hospitalization or death at 1 year.

Nebulized heparin may reduce fibrin cast formation and reduce the degree of airway obstruction in burn inhalation injury. Twenty-nine patients admitted to burn intensive care unit (ICU) within 24 hours of burn inhalation injury were included in this prospective double-blinded randomized study. Group H5 received nebulized heparin sulfate 5,000 IU, and group H10 received nebulized heparin sulfate 10,000 IU. Heparin was given in alternation with N-acetylcysteine every 2 hours. Lung injury score assessed daily for 7 days was the primary outcome. Duration of mechanical ventilation, coagulation profile, length of ICU stay, and mortality were the secondary outcomes. Median lung injury scores were significantly lower in group H10 on days 5 (1.9 vs 1), 6 (1.4 vs 0.5), and 7 (1.3 vs 0.5). Group H10 had also a lower duration of mechanical ventilation than did group H5 (P = .037). The groups had no significant difference in coagulation parameters, length of ICU stay (P = .17), and mortality (P = .6). Nebulized heparin 10,000 IU decreased lung injury scores and duration of mechanical ventilation but had no effect on length of ICU stay and mortality. Moreover, nebulized heparin 10,000 IU was safe and had no effect on coagulation parameters.

The plasticizer di(2-ethylhexyl) phthalate (DEHP) is ubiquitous in the environment and considered as carcinogen; however, the carcinogenic risk of human exposure to DEHP in the air via inhalation is lacking. A probabilistic incremental lifetime cancer risk (ILCR) model was implemented to quantitatively estimate the potential cancer risk of DEHP via human inhalation by using Monte Carlo simulation. We assessed the cancer risk in different age groups (children, adolescents, and adults) exposed to different DEHP concentrations (background low, indoor moderate, and occupational high) for different durations (2, 8, and 20 years). Results showed that the cancer risk of exposure to DEHP was below the acceptable limit (10 −6 ) in the ambient air but was serious in indoor and occupational environments even at short exposure duration (2 years). The cancer risk of DEHP via inhalation in children was lower than that in adolescents and adults, but the risk in children via dermal and oral exposure to indoor dust and soft PVC toys should be considered. Sensitivity analysis indicated that the exposure concentration of DEHP was the strongest factor that influenced ILCR. Our work provides the evidence of cancer risk of DEHP via inhalation and highlights the risk in indoor and occupational environments.

Long-term oxygen therapy, the first intervention that was shown to improve survival in patients with both severe hypoxemia and chronic obstructive pulmonary disease (COPD), had an effect size so large that data from fewer than 300 patients were all that was needed to establish its efficacy. In the Nocturnal Oxygen Therapy Trial (NOTT), performed in North America, 203 patients with COPD and severe hypoxemia were randomly assigned to receive continuous oxygen supplementation (24 hours per day) or nocturnal oxygen therapy for 12 hours per day. 1 In another trial, which was conducted by the U.K. Medical Research Council (MRC), 15 hours . . .

With a growing awareness of environmental protection, the dust pollution caused by automobile foundry work has become a serious and urgent problem. This study aimed to explore contamination levels and health effects of automobile foundry dust. A total of 276 dust samples from six types of work in an automobile foundry factory were collected and analysed using the filter membrane method. Probabilistic risk assessment model was developed for evaluating the health risk of foundry dust on workers. The health risk and its influencing factors among workers were then assessed by applying the Monte Carlo method to identify the most significant parameters. Health damage assessment was conducted to translate health risk into disability-adjusted life year (DALY). The results revealed that the mean concentration of dust on six types of work ranged from 1.67 to 5.40 mg/m3. The highest health risks to be come from melting, cast shakeout and finishing, followed by pouring, sand preparation, moulding and core-making. The probability of the risk exceeding 10−6 was approximately 85%, 90%, 90%, 75%, 70% and 45%, respectively. The sensitivity analysis indicated that average time, exposure duration, inhalation rate and dust concentration (C) made great contribution to dust health risk. Workers exposed to cast shakeout and finishing had the largest DALY of 48.64a. These results can further help managers to fully understand the dust risks on various types of work in the automobile foundry factories and provide scientific basis for the management and decision-making related to health damage assessment.

PurposeWelders are more likely to develop neurobehavioral disorders because of their exposure to neurotoxic metals such as manganese. This study aimed to measure the neurobehavioral performance of welders occupationally exposed to manganese at welding enterprises and its relationship with the workplace environment.MethodsIt is a comparative cross-sectional study carried out on 130 welders working at 50 welding enterprises in Menoufia governorate, Egypt, compared to 130 non-occupationally exposed controls.ResultsIt was found that the environments of the studied welding enterprises had levels of respirable dust, manganese, and total welding fumes that exceeded internationally permissible limits. In addition, the mean blood manganese levels were significantly higher among welders (4.16 ± 0.61) than the controls (1.72 ± 0.41). Welders had a significantly higher prevalence of neurological manifestations and lower performance of neurobehavioral tests. Lower neurobehavioral performance among welders was significantly correlated with increased work duration and blood levels in some tests.ConclusionTo lessen the fumes in the breathing zone of workers, it is therefore strongly recommended to regularly wear high-quality personal protective equipment, especially masks, and to ensure proper ventilation.

Nasal high-flow therapy (NHFT) is an upcoming treatment for chronic obstructive pulmonary disease (COPD) patients. It supplies heated, humidified, and, desirably, oxygen-enriched air through a nasal cannula at flow rates up to 60 L/min. Several studies examined the effect of NHFT in COPD patients, but a clear overview is lacking. The present review aimed to give an overview of the clinical evidence of NHFT in 3 aspects of COPD care: long-term use in stable COPD patients, use for treatment of COPD exacerbations, and use during exercise therapy in COPD. For each topic, a specific literature search was performed up to December 9, 2019. Studies show promising results, with most evidence for its long-term use in hypoxemic COPD patients that frequently exacerbate, and very limited evidence for its use during COPD exacerbations or as a worthwhile adjunct to exercise training. More evidence is therefore needed to know how to incorporate NHFT in standard clinical practice.

The study presents seasonal changes in nitrosamine concentrations in inhalable particulate matter (PM 10 ) collected from the atmosphere of Zonguldak, Turkey, during heating and non-heating periods, possible source apportionment, and risk assessment of human health. The daily collected PM 2.5 and PM 2.5–10 samples were analyzed for nitrosodimethylamine, nitrosomethylethylamine, nitrosodiethylamine, nitrosopyrrolidine, nitrosodipropylamine, nitrosomorpholine, nitrosoethylbutylamine, nitrosopiperidine, mono-nitrosopiperazine, di-nitrosopiperazine, nitrosodibutylamine, and nitrosodiphenylamine by gas chromatography – mass spectrometry (GC–MS). The mean concentrations of total nitrosamines in PM 10 were found to be 19.04 ng/m 3 in summer, 113.67 ng/m 3 in winter, and 98.88 ng/m 3 annually, with a peak of 253.56 ng/m 3 occurring in winter. The source apportionment of the analyzed data was conducted using principal component analysis, resulting in two primary factors: “Coal-Fuel Oil Combustion-Cooking” and “Traffic Emissions-Secondary Atmospheric Reaction-Landfill.” These two factors collectively accounted for 82.944% of the total variance. In order to evaluate the health risks associated with the inhalation of mutagenic and carcinogenic nitrosamines present in airborne PM 10 , cumulative lifetime cancer risks (LCR) were calculated for different age groups based on exposure time (ET) using annual mean concentrations. The average cumulative lifetime cancer risks, represented as the number of additional cancer cases per million exposed population , were in the range of 1.57–12.57 for the 0– < 1 age group, 4.18–33.52 for the 1– < 6 age group, 5.48–43.96 for the 6– < 21 age group, and 7.70–61.61 for the 21 < 70 age group. The estimated average cumulative lifetime cancer risks from inhalation exposure to nitrosamines in urban PM10 exceed the US Environmental Protection Agency’s guideline for a negligible risk level of 1 excess cancer case per 1 million exposed individuals across all age groups. LCRs exceed the maximum acceptable value of 10 at different exposure times in all age groups but do not exceed the intolerable value of 100 in any age group.

This study aims to determine the potential health risks (Carcinogenic and non-carcinogenic) of metal(loid)s in sewage sludge samples for agricultural purposes. For this purpose, sewage sludge was collected annually from a domestic wastewater treatment plant, and metal(loid)s were determined by ICP-MS. Metal(loid)s concentration in sludge samples was within the legal standards. No statically significant seasonal variation of metal(loid)s were observed. The total cancer risk and the hazard index (HI) of metal(loid)s through ingestion, dermal, and inhalation exposure from sewage sludge samples were estimated. The main risk contributor to metal(loid)s were Pb, Zn, and Ni. The average HI values were 0.75 (child) and 0.09 (adult). The total carcinogenic risk (TCR) for child and adult was found to be 3.43 × 10 –5 and 2.31 × 10 –5 , respectively. EPA risk assessment model and Monte Carlo Simulation were used to estimate probability and sensitivity distributions for carcinogenic and non-carcinogenic risks. Sensitivity analysis showed that metal(loid)s concentration, exposure duration, exposure frequency, and body weight significantly affect total health risk. The sewage sludge can be applied safely in agriculture due to no important carcinogenic and non-carcinogenic risk for child and adult. Graphical Abstract