authors: oana cristina arghir ¹ , anamaria bechir ² , gheorghita voicu ³

The Prevalence of Respiratory Diseases according with the level of Tobacco Dependence among

an oil company workers

Authors: Oana Cristina Arghir¹, Anamaria Bechir², Gheorghita Voicu³

¹Constanta "Ovidius" University²Bucharest "Titu Maiorescu" Faculty³Constanta Clinical Pneumology Hospital

Settings:

• Considering that a given environmental chronical exposure to chemical substances used in oil industry may influence the risk of occupational respiratory pathology, our study proposed to assign the prevalence of respiratory diseases, moslty COPD, concerning on the role of additional smoking exposure in an oil company’s workers from an south-eastern Romanian region.

General characteristics of randomized persons grouped by direct exposure to chemical air polution

Chemical substances used in oil industry processes

Organic solvents: aliphatic and aromatic hydrocarbons,

Petroleum solvents, acids,

Respirable dust

Workers may be at risk for lung diseaseif the air they breathe at work containsan excessive amount of dust, fumes, smoke, gases, vapors or mists. Workers who smoke are at a much greater risk of lung disease if they are exposed to substances in the workplace that can cause lung disease. Poor ventilation, closed-in working areas and heat increase the risk of disease. Outside air pollution can also increase the risk of lung disease in people who work in jobs that expose them to substances that can cause lung disease.

Purpose:

• To collect available data on nicotine dependence, as defined by the Fargerstrőm Test of Nicotine Dependence (FTND);

• To compare levels of dependence among exposed workers, assigning the prevalence of smoking and respiratory diseases, especially COPD prevalence.

Material & methods:• Prevalence study conducted from in 2002 consisted in a

two part process of symptom-based questionnaire inspired by ECRHS and FTND;

• The prevalence study included subjects identified as exposed workers with a perriod of exposure > one year.

• Those who reported respiratory symptoms, by using a simplified questionnaire (inspired by ECRHS),

• were selected, • performed lung function tests (Flow Screen Jaeger

device, • and interogated with more details about smoking, follow-

up FTND questioning of active smokers.

Results:• 202 were identified as exposed workers (E) with a mean perriod of

exposure of 12.4 yrs +/- 7.253 s.d. (lim: 1-32 yrs.).

• 65.35% of workers reported respiratory symptoms (n=132/202),

• 84% of randomized workers (n=111/132) had a suggestive symptom- based questionnaire for a respiratory disease;

• 60.79% of all workers recognized smoking (n=143/202);

• 93 of them recognized tobacco dependence, according to FTND (with 4 different degree of nicotine dependence).

Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The Fagerstrom Test for Nicotine Dependence : a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict 1991; 86(9):1119-27. Br J Addict 1991; 86 (9) :1119-27.

Interpretation of FTND results

Score between 0-3: Low dependence

Score between 4-5: Average dependence

Score between 6-7: Strong dependence

Score between 8-10: Extreme dependence

The prevalence of respiratory diseases and disorders among workers

The prevalence of respiratory diseases and disorders among active smokers workers

Impact of smoking on COPD among oil company workers

Prevalence of COPD was greater in active smokers (n= 43/93; 46%)

0

50

100

150

1 2 3

COPD NO

COPD YES

1 Ex-smokers 12/50; 24%2 Non smokers 8/59; 13.5%;3 Active smokers 48/93; 51.6%

p<0.002

0

5

10

15

20

25

30

35

40

Activesmokers

COPD yes COPD no

Low dependence

Above averagedependenceStrong dependence

Extremelydependence

FTND Score dependence severity among smokers +/- COPD

The impact of nicotine dependence on COPD Prevalence

[COPD Prevalence: 33.6% in oil Company workers (n= 68/202)]

0% 20% 40% 60% 80% 100%

COPD YES

COPD NO

0-3 points

4-5 points

6-7 points

8-10 points

0% 20% 40% 60% 80% 100%

0-3 points

4-5 points

6-7 points

8-10 points

COPD yes

COPD no

The impact of nicotine dependence on COPD Prevalence, according with FTND

COPD Prevalence has a progressive increase among smokers, according with the degree of nicotine dependence (from low: 38.9% to extreme 91.6%).

Conclusions:

• The prevalence of respiratory disease in oil company exposed workers is significantly correlated with smoking addiction.

• A simple FTND can be used to identify patients with a high likelyhood of having COPD, for whom strong dependence is particularly important (mostly to eliminate the occupational exposure component).

Clinical Implications:

• Most respiratory guidelines agree that spirometry is the basis for COPD diagnosis and Fagerstrőm Test of Nicotine Dependence might enhance the diagnostic accuracy of COPD.

Thank you!

Please, stop smoking!

arghir_oana@yahoo.com