ABSTRACT
Background: Understandable, comprehensive, and accessible educational materials for patients with interstitial lung disease (ILD) are lacking. Patients consistently ask for improved access to evidence-based information about ILD. Nonetheless, few research studies focus directly on developing and evaluating interventions to improve patient knowledge. Objective: We describe the current landscape of patient education in ILD, identify gaps in current approaches to information delivery, and provide frameworks to address these challenges through novel educational tools. Methods: A literature review was conducted in collaboration with a medical librarian (M.R.D.) in April 2022 using Ovid MEDLINE (1946-), Embase (1947-), Cochrane Central (1993-), and CINAHL (1961-). Search terms included "interstitial lung disease," "pulmonary fibrosis," "patient education," and "information seeking behavior" (see the data supplement for full search terms). Reference lists from selected articles were used to identify additional studies. Results: Currently, patient education is commonly combined with exercise regimens in pulmonary rehabilitation programs in which benefits of the educational component alone are unclear. Few studies investigate improving knowledge access and acquisition for patients with ILD and their caregivers regarding self-management, oxygen use, and palliative care plans. Online distribution of health information through social media runs the risk of being unregulated and outdated, although it is an avenue of increasing accessibility. Conclusion: By expanding access to novel ILD-specific education programs and accounting for social determinants of health that impact healthcare access, patient education has the potential to become more attainable, improving patient-centered outcomes. Further research into optimal development, delivery, and efficacy testing of patient education modalities in ILD is warranted.
ABSTRACT
PURPOSE OF REVIEW: Per- and polyfluoroalkyl substances (PFAS) are a family of more than 7,000 fluorinated compounds. The carbon-fluorine bond of PFAS provides desirable hydrophobic and oleophobic properties and stability that has led to widespread usage in consumer products and industrial applications. The strength of the carbon-fluorine bond also prevents appreciable degradation once released into the environment. Consequently, various household products can release volatile and nonvolatile PFAS into the indoor environment that often concentrate in dust. We discuss the diversity of PFAS in settled dust, emission sources of these chemicals, changes in PFAS profiles in dust over the past century, and the implications for human health. RECENT FINDINGS: Sources of PFAS found in dust include building materials and furnishings and consumer products used in typical indoor spaces. Daycares and workplaces are emphasized as locations with widespread exposure due to the presence of treated carpeting and industrial-strength cleaners. Comparison and interpretation of findings across studies are complicated by the different ways in which PFAS are screened across studies. We further discuss recent developments in non-targeted software for the comprehensive annotation of PFAS in indoor dust and emphasize the need for comprehensive and harmonized analytical workflows. We highlight the detection and diversity of PFAS in settled dust collected from various indoor spaces, including locations with vulnerable subpopulations. There are opportunities for future research to leverage settled dust as a sentinel environmental matrix to evaluate the link between inhalation and ingestion routes of PFAS exposure to adverse health.
Subject(s)
Air Pollution, Indoor , Fluorocarbons , Dust , Humans , PrevalenceABSTRACT
Thousands of per- and polyfluoroalkyl substances (PFAS) exist in the environment and pose a potential health hazard. Suspect and nontarget screening with liquid chromatography (LC)-high-resolution tandem mass spectrometry (HRMS/MS) can be used for comprehensive characterization of PFAS. To date, no automated open source PFAS data analysis software exists to mine these extensive data sets. We introduce FluoroMatch, which automates file conversion, chromatographic peak picking, blank feature filtering, PFAS annotation based on precursor and fragment masses, and annotation ranking. The software library currently contains â¼7â¯000 PFAS fragmentation patterns based on rules derived from standards and literature, and the software automates a process for users to add additional compounds. The use of intelligent data-acquisition methods (iterative exclusion) nearly doubled the number of annotations. The software application is demonstrated by characterizing PFAS in landfill leachate as well as in leachate foam generated to concentrate the compounds for remediation purposes. FluoroMatch had wide coverage, returning 27 PFAS annotations for landfill leachate samples, explaining 71% of the all-ion fragmentation (CF2)n related fragments. By improving the throughput and coverage of PFAS annotation, FluoroMatch will accelerate the discovery of PFAS posing significant human risk.
