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Fungal contamination of the respiratory tract and associated respiratory impairment among sawmill workers in India

Asit Adhikari, Subhashis Sahu, Arghya Bandyopadhyay, Paul D. Blanc, Subhabrata Moitra
ERJ Open Research 2015 1: 00023-2015; DOI: 10.1183/23120541.00023-2015
Asit Adhikari
1Ergonomics and Occupational Physiology Laboratory, Department of Physiology, University of Kalyani, Kalyani, India
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Subhashis Sahu
1Ergonomics and Occupational Physiology Laboratory, Department of Physiology, University of Kalyani, Kalyani, India
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Arghya Bandyopadhyay
2Department of Chemical Sciences, Indian Institute of Science Education and Research, Kolkata, India
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Paul D. Blanc
3Division of Occupational and Environmental Medicine, University of California San Francisco, San Francisco, CA, USA
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Subhabrata Moitra
4Molecular Respiratory Research Laboratory, Chest Research Foundation, Pune, India
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  • For correspondence: subhabrata2207@gmail.com
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Figures

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  • FIGURE 1
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    FIGURE 1

    Phylogenetic tree for 11 taxa of Candida (see Methods section for further details).

  • FIGURE 2
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    FIGURE 2

    Prevalence of symptoms among the sawmill workers comparing those with and without fungus-positive sputum samples.

Tables

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  • TABLE 1

    Characteristics of 54 wood mill worker study participants

    ParametersFungus positiveFungus negativep-value
    Participants n1935
    Age years42.5±10.436.9±5.20.04
    Height cm172.05±4.76173.20±5.420.43
    BMI kg·m−221.9±3.321.2±2.30.44
    Ever-smokers8 (42.1)12 (34.3)0.79
    Employment years15.8±8.113.0±4.20.18
    Parental asthma6 (31.6)7 (20.0)0.54
    • Data are presented as mean±sd or n (%), unless otherwise stated. All participants were male. p-values are based on t-test for age and height, Wilcoxon rank sum test for body mass index (BMI) and employment years, and Chi-squared test for smoking status and parental asthma.

  • TABLE 2

    Comparison of lung function by fungal status among 54 woodworkers

    ParametersFungus positiveFungus negativep-value
    Participants n1935
    FVC L2.83±0.302.89±0.240.44
    FVC % predicted79.0±8.278.0±8.30.70
    FEV1 L2.12±0.292.20±0.280.36
    FEV1 % predicted76.7±10.275.2±11.20.61
    FEV1/FVC0.75±0.040.76±0.060.47
    FEF25–75% L·s−12.59±0.552.98±0.470.01
    FEF25–75% % predicted69.2±9.9582.3±4.53<0.01
    • Data are presented as mean±sd unless otherwise stated. FVC: forced vital capacity; FEV1: forced expiratory volume in 1 s; FEF25–75%: forced expiratory flow at 25–75% of FVC.

  • TABLE 3

    Comparison of inflammatory cellular profile in the sputum between the study groups

    Sputum
    cell type
    Fungus positive#Fungus negative¶
    Median (interquartile range)RangeMedian (interquartile range)Range
    Neutrophils %62.75 (58.0–67.25)52.25–69.563.25 (62.25–66.25)57.75–72.25
    Eosinophils %9.25 (8.5–10.25)6.75–11.53.25 (2.5–4.25)1.5–5.25
    Macrophages %22.5 (18.75–28.5)16.75–33.7531.25 (29.5–32.625)24.0–35.5
    Lymphocytes %4.25 (3.75–4.875)3.5–7.51.75 (1.25–2.125)0.5–4.25
    • Group-wise comparison (ANOVA), p<0.01. #: n=19; ¶: n=35.

  • TABLE 4

    Mediation analysis for the association between fungal appearance, lung function and sputum inflammatory cells

    ModelPredictorsFEF25–75% % predicted
    β (95% CI)p-valueR2
    Model 1Fungus positivity−12.7 (−16.9– −8.5)<0.0010.45
    Model 2Eosinophil %−2.1 (−2.8– −1.5)<0.0010.49
    Model 3Fungus positivity−3.5 (−13.9–6.9)0.510.48
    and eosinophil %−1.6 (−3.3–0.06)0.06
    • All models included age, smoking status (current versus former or never) and years of employment. FEF25–75%: forced expiratory flow at 25–75% of forced vital capacity; β: adjusted regression coefficient; R2: determination coefficient.

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Fungal contamination of the respiratory tract and associated respiratory impairment among sawmill workers in India
Asit Adhikari, Subhashis Sahu, Arghya Bandyopadhyay, Paul D. Blanc, Subhabrata Moitra
ERJ Open Research Oct 2015, 1 (2) 00023-2015; DOI: 10.1183/23120541.00023-2015

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Fungal contamination of the respiratory tract and associated respiratory impairment among sawmill workers in India
Asit Adhikari, Subhashis Sahu, Arghya Bandyopadhyay, Paul D. Blanc, Subhabrata Moitra
ERJ Open Research Oct 2015, 1 (2) 00023-2015; DOI: 10.1183/23120541.00023-2015
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