Dong Yutong, Cromer Pam, Layman Debbie, Altvater Michelle, Dong Yanbin, Zhu Haidong
Pulmonary-Critical Care Fellowship, Mount Sinai Hospital, 1468 Madison Ave, New York, NY, 10029, USA.
College of Nursing, Augusta University, Augusta, GA, USA.
BMC Pulm Med. 2024 Dec 30;24(1):636. doi: 10.1186/s12890-024-03382-2.
Small airways disease (SAD) is a key risk in developing obstructive lung diseases (OLD). Handgrip strength (HGS) is found to be associated with pulmonary function in populations with lung conditions. Hispanics remain the main workforce in farming industry, but their prevalence of lung conditions remain understudied. Likewise, HGS also remains understudied in Hispanic and farmworker populations. Our study investigated the prevalence of SAD and OLD as well as their associations with HGS among Hispanic farmworkers.
A cross-sectional study analyzed 113 Hispanic farmworkers (54% female) who were screened using pulmonary function tests during annual health fairs in rural Southeastern US from 2013 to 2017. Smoking status was self-reported. SAD was defined as forced expiratory flow at 25-75% predicted of vital capacity (FEF) ≤ 60% per literature and OLD defined as forced expiratory volume in 1 s/ forced vital capacity (FEV1/FVC) ratio < 70% per Global Initiative for Chronic Obstructive Lung Disease criteria. Seated isometric absolute (the sum of both hands) and relative (absolute handgrip strength divided by body mass index) handgrip strengths were collected.
26.5% of subjects had SAD and 15.9% had OLD. 50% of subjects with SAD had OLD while 83% of subjects with OLD had SAD. 13% of overall population smoked. Lower absolute and relative HGS groups had higher prevalence of SAD and OLD. Multivariate linear regression showed that lower absolute and relative HGS were associated with worsened small airway function. Age and FEF were associated with FEV1/FVC. Smoking, body mass index, blood pressures, hemoglobin A1C and lipids were not predictors in either model.
This is one of the first studies reporting prevalence of pulmonary function in Hispanic farmworkers. Although this population was relatively young and healthy, there was high prevalence of SAD and OLD, which was higher than the overall prevalence in Hispanic population. There were more females subjects with SAD. Most of the subjects with OLD had SAD but not vice versa. Lower HGS levels were associated with worsened pulmonary function, and HGS was a significant predictor of FEF, a potential marker for small airway physiology.
小气道疾病（SAD）是发展为阻塞性肺疾病（OLD）的关键风险因素。研究发现，握力（HGS）与肺部疾病人群的肺功能相关。西班牙裔仍然是农业产业的主要劳动力，但他们肺部疾病的患病率仍未得到充分研究。同样，西班牙裔和农场工人人群的握力情况也未得到充分研究。我们的研究调查了西班牙裔农场工人中SAD和OLD的患病率及其与握力的关联。
一项横断面研究分析了113名西班牙裔农场工人（54%为女性），这些人于2013年至2017年在美国东南部农村地区的年度健康集市期间接受了肺功能测试筛查。吸烟状况由自我报告获得。根据文献，SAD定义为肺活量（FEF）预计值的25%-75%时的用力呼气流量≤60%，OLD根据慢性阻塞性肺疾病全球倡议标准定义为1秒用力呼气量/用力肺活量（FEV1/FVC）比值<70%。收集坐位等长绝对（双手之和）和相对（绝对握力除以体重指数）握力。
26.5%的受试者患有SAD，15.9%的受试者患有OLD。50%的SAD受试者患有OLD，而83%的OLD受试者患有SAD。总体人群中13%吸烟。较低的绝对和相对握力组中SAD和OLD的患病率较高。多变量线性回归显示，较低的绝对和相对握力与小气道功能恶化相关。年龄和FEF与FEV1/FVC相关。吸烟、体重指数、血压、糖化血红蛋白A1C和血脂在两个模型中均不是预测因素。
这是首批报告西班牙裔农场工人肺功能患病率的研究之一。尽管该人群相对年轻且健康，但SAD和OLD的患病率较高，高于西班牙裔人群的总体患病率。患有SAD的女性受试者更多。大多数患有OLD的受试者患有SAD，但反之则不然。较低的握力水平与肺功能恶化相关，握力是FEF的重要预测因素，FEF是小气道生理学的一个潜在标志物。
