Quality of Life and Bronchial Hyper-Responsiveness in Subjects With Bronchiectasis: Validation of the Seattle Obstructive Lung Disease Questionnaire in Bronchiectasis.

BACKGROUND: Bronchiectasis can adversely affect quality of life. However, the tests examining quality of life in bronchiectasis are not sufficient. We examined the validity of a measure designed for COPD, the Seattle Obstructive Lung Disease Questionnaire (SOLQ), in bronchiectasis. In addition, we aimed to compare the quality of life of subjects with bronchiectasis and bronchial hyper-responsiveness with that of those without to identify the effective factors. METHODS: We studied 78 subjects with clinically stable bronchiectasis and 41 healthy controls matched for age and sex. Subjects were assessed by the SOLQ. A detailed history, physical examination, the Medical Outcomes Study 36-Item Short Form questionnaire, the Hospital Anxiety and Depression Scale, and spirometric measurements were obtained. RESULTS: Cronbach α coefficients, which reflected internal consistency, were >0.70 for all SOLQ components except for treatment satisfaction. SOLQ component scores correlated with all of the component scores of the Medical Outcomes Study 36-Item Short Form questionnaire and the Hospital Anxiety and Depression Scale, confirming their concurrent validity. All SOLQ scores correlated positively with percent-of-predicted FEV1, whereas the physical function, treatment satisfaction, and emotional function correlated negatively with the exacerbation frequency in Pearson analysis. Emotional and physical functions were positively associated with percent-of-predicted FEV1 in linear regression analysis. Compared with subjects without bronchial hyper-responsiveness, those with bronchial hyper-responsiveness had lower FEV1/FVC and more exacerbations/y. Compared with bronchiectasis subjects without bronchial hyper-responsiveness, those with bronchial hyper-responsiveness had significantly lower SOLQ, physical function, and coping skills scores but not emotional function and treatment satisfaction. CONCLUSIONS: The SOLQ is a valid instrument for determining quality of life in subjects with bronchiectasis. Subjects with bronchiectasis and bronchial hyper-responsiveness had a poorer quality of life, lower baseline spirometric values, and more frequent exacerbations, suggesting more severe disease.

Obstructive airway diseases in women exposed to biomass smoke.

The majority of women living in rural areas in Turkey use biomass fuels for domestic energy and are exposed to high levels of indoor air pollution every day. The objective of this study was to compare the presence of chronic airway diseases (CAD) in two groups of nonsmoking women older than 40 years with (exposed group, n=397) and without a history of exposure to biomass cooking (liquid petroleum gas (LPG); control group, n=199), in 2002 in Kirikkale, Turkey. Detailed respiratory symptoms were collected with a standard questionnaire adapted from that of the British Medical Research Council. Exposure was calculated as the average hours spent daily for cooking multiplied by the number of years. CAD were defined as either chronic airway obstruction (CAO; (forced expiratory volume in 1s/forced vital capacity)<0.70), chronic bronchitis, or chronic bronchitis with CAO. The prevalence of CAD in the exposed group was found to be higher than that in the LPG group (28.5% vs. 13.6%, crude odds ratios (ORs) 2.5 (1.5--4.0), P=0.0001). The fraction of CAD attributed to exposure to biomass smoke after adjusting for possible confounding factors was 23.1% (95% confidence interval (CI) 13.4--33.2). Acute symptoms during exposure to biomass smoke were important predictors for the presence of CAD. Biomass smoke pollution is an important contributing factor in the development of CAD in nonsmoking women living in a rural area. The presence of acute symptoms during cooking in women in rural areas should signal to general practitioners the possibility of CAD.

Psychological status and quality of life in elderly patients with asthma.

The psychological status and quality of life of 70 stable patients with asthma age > or =60 years and 40 age-matched comparison subjects were examined. The patients with long-standing asthma (duration > or = 8 years) had lower quality-of-life scores than those with recent-onset asthma (duration < 8 years). In multivariate linear regression analysis with adjustment for age, gender duration of disease, and level of bronchial hyperreactivity, worse quality of life was predicted by anxiety, depression, and asthma severity scores. In elderly patients with long-standing asthma, disease severity significantly impairs quality of life. Impaired quality of life in these patients may be partly related to psychological status indicators.

Respiratory findings in gun factory workers exposed to solvents.

OBJECTIVE: Gun factory workers are exposed to many solvents (toluene, acetone, butanol, xylene, benzene, trichloroethylene). We investigated whether chronic exposure to solvents had adverse effect on respiratory system. MATERIAL AND METHODS: The workers were questionnaired by modified Medical Research Council's respiratory questionnaire before morning start shift. Then physical examination and measurement of pulmonary functions by portable dry rolling spirometer were performed. The study group consisted of 1091 gun factory workers. The workers were grouped according to their smoking habits (smokers, [exposed n: 353 vs. unexposed n: 339] and non-smokers [exposed n: 58 vs. unexposed n: 341]). Asthma-related symptoms were defined as either definite asthma, probable asthma, and possible asthma. RESULTS: In non-smokers, the report of asthma-related symptoms was more prevalent in exposed workers than unexposed (39.7% vs. 21.7% OR 2.4[1.3-4.3], respectively P = 0.003). In smokers, the report of asthma-related symptoms was more common in exposed group than unexposed (50.7% vs. 42.5% OR 1.4[1.0-1.9], respectively P = 0.03). Logistic regression analysis showed that smoking (OR 2.8[2.0-3.8] P = 0.00001) and exposure to solvents (OR 1.4[1.1-1.9] P = 0.01) were independent risk factors for asthma-related symptoms, after adjusting for age. Logistic regression analysis identified that smoking (OR 3.3[2.3-4.6] P = 0.00001) was independent risk factors for chronic bronchitis. Multiple linear regression analysis of lung-function parameters (% forced expiratory volume (FEV1), FEV1/forced vital capacity, FEF(25-75)) indicated significant effects of smoking. CONCLUSION: Present study indicated significant effects of smoking and exposure to solvents, with the smoking effect being the most important on asthma-related symptoms of gun factory workers.

Perception of bronchoconstriction in obstructive pulmonary diseases (disease-specific dyspnoea).

The perception of dyspnoea differs between subjects with obstructive pulmonary diseases, partly because the underlying mechanisms for bronchoconstriction are different. We investigated the perception of bronchoconstriction in subjects with bronchiectasis, asthma and chronic bronchitis and possible contributing factors. Forty-seven non-smoking subjects with bronchiectasis, 50 subjects with asthma and 31 with chronic bronchitis were challenged with histamine. The Borg score was assessed before and after each challenge. The perception score corresponding to a fall in the forced expiratory volume in 1 s (FEV(1)) by 20% (PS(20)) was calculated. The mean values of DeltaBorg/DeltaFEV(1) (the Borg score change divided by the change in FEV(1) as a percentage of the baseline FEV(1)) and PS(20) of subjects with bronchiectasis and chronic bronchitis were significantly lower than in subjects with asthma after histamine challenge. The ratio of non-perceivers was higher in bronchiectasis (25.5%) and in chronic bronchitis (32.3%) than in asthma (4.0%). When all subjects were considered, DeltaBorg/DeltaFEV(1) values were significantly related to female sex ( r (2)=11.5%, P =0.0001), but not to age, duration of the disease, PD(20) or baseline FEV(1)%. The present study indicates that perception of histamine-induced bronchoconstriction is lower in patients with bronchiectasis and chronic bronchitis than in asthmatic patients, and that sex partially contributes to this difference.