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Early changes in respiratory health in young apprentices and physician utilization for asthma and bronchitis later in life Peters, Cheryl Elizabeth
Abstract
Introduction: The main risk factors for the development of respiratory disease have been largely established, however we still cannot predict which individuals will develop respiratory morbidity later in life. This study had two main goals: 1) to examine early working-life changes in respiratory health as risk factors for the development of asthma and bronchitis, and 2) to assess the utility of healthcare utilization data for longitudinal studies in respiratory epidemiology. Methods: A cohort of young apprentices at entry to their trade (machining, construction painting, insulating, and electrician) was enumerated in 1988 to study prospectively the natural history of respiratory morbidity. This group (n=356) was followed-up again two years later. Subjects were linked to a provincial database of all healthcare encounters from 1991 to 2004 (linkage rate 98%). Two health outcomes were studied using physician diagnosis codes: asthma and "bronchitis". Demographics, smoking, spirometric variables, and respiratory symptoms were assessed as predictors of both becoming a respiratory case (logistic regression), and of physician visit rate (negative binomial regression) during the administrative follow-up. Results: There were 281 subjects available for analysis (complete data from baseline, first follow-up, administrative data). Sixteen met the case definition for asthma (2 physician visits in 1 year), and 20 met the case definition for "bronchitis" (3 visits in 1 year). Baseline bronchial responsiveness (BR), and especially a rapid increase in BR over the first 2 years was a strong risk factor for both asthma and "bronchitis". Baseline symptoms of chronic cough or phlegm were predictive of subsequent "bronchitis" visits, and incident asthma-like symptoms were strongly related to subsequent asthma visits. Lung function variables were not important in any models. Relationships were also detected between type of physician, age, sex, job title, size of town, smoking status and the type of respiratory diagnostic code assigned at each physician visit. Conclusions: Early changes in respiratory health may be useful markers in a surveillance program of workers who are susceptible to subsequent obstructive lung disease. Health care utilization data is a unique and promising tool in respiratory epidemiology.
Item Metadata
Title |
Early changes in respiratory health in young apprentices and physician utilization for asthma and bronchitis later in life
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Creator | |
Publisher |
University of British Columbia
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Date Issued |
2007
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Description |
Introduction: The main risk factors for the development of respiratory disease have
been largely established, however we still cannot predict which individuals will develop
respiratory morbidity later in life. This study had two main goals: 1) to examine early
working-life changes in respiratory health as risk factors for the development of asthma
and bronchitis, and 2) to assess the utility of healthcare utilization data for longitudinal
studies in respiratory epidemiology.
Methods: A cohort of young apprentices at entry to their trade (machining,
construction painting, insulating, and electrician) was enumerated in 1988 to study
prospectively the natural history of respiratory morbidity. This group (n=356) was
followed-up again two years later. Subjects were linked to a provincial database of all
healthcare encounters from 1991 to 2004 (linkage rate 98%). Two health outcomes
were studied using physician diagnosis codes: asthma and "bronchitis". Demographics,
smoking, spirometric variables, and respiratory symptoms were assessed as predictors
of both becoming a respiratory case (logistic regression), and of physician visit rate
(negative binomial regression) during the administrative follow-up.
Results: There were 281 subjects available for analysis (complete data from baseline,
first follow-up, administrative data). Sixteen met the case definition for asthma (2
physician visits in 1 year), and 20 met the case definition for "bronchitis" (3 visits in 1
year). Baseline bronchial responsiveness (BR), and especially a rapid increase in BR
over the first 2 years was a strong risk factor for both asthma and "bronchitis". Baseline
symptoms of chronic cough or phlegm were predictive of subsequent "bronchitis" visits,
and incident asthma-like symptoms were strongly related to subsequent asthma visits.
Lung function variables were not important in any models. Relationships were also
detected between type of physician, age, sex, job title, size of town, smoking status and
the type of respiratory diagnostic code assigned at each physician visit.
Conclusions: Early changes in respiratory health may be useful markers in a
surveillance program of workers who are susceptible to subsequent obstructive lung
disease. Health care utilization data is a unique and promising tool in respiratory
epidemiology.
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Genre | |
Type | |
Language |
eng
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Date Available |
2011-03-09
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Provider |
Vancouver : University of British Columbia Library
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Rights |
For non-commercial purposes only, such as research, private study and education. Additional conditions apply, see Terms of Use https://open.library.ubc.ca/terms_of_use.
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DOI |
10.14288/1.0101091
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URI | |
Degree | |
Program | |
Affiliation | |
Degree Grantor |
University of British Columbia
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Campus | |
Scholarly Level |
Graduate
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Aggregated Source Repository |
DSpace
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Rights
For non-commercial purposes only, such as research, private study and education. Additional conditions apply, see Terms of Use https://open.library.ubc.ca/terms_of_use.