Martha Powers1, Tiffany R Sanchez2, Thomas K Welty3, Shelley A Cole4, Elizabeth C Oelsner5, Fawn Yeh6, Joanne Turner4, Marcia O'Leary7, Robert H Brown1,8, Max O'Donnell9,10, David Lederer5,10, Ana Navas-Acien1,2. 1. Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 2. Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York. 3. Retired U.S. Public Health Service, Tuba City, Arizona. 4. Texas Biomedical Research Institute, San Antonio, Texas. 5. Department of Medicine, and. 6. Center for American Indian Health Research, University of Oklahoma Health Sciences Center, College of Public Health, Oklahoma City, Oklahoma. 7. Missouri Breaks Industries Research, Inc., Eagle Butte, South Dakota. 8. Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland. 9. Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Irving Medical Center, New York, New York. 10. Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York.
Abstract
Rationale: Permanent lung function impairment after active tuberculosis infection is relatively common. It remains unclear which spirometric pattern is most prevalent after tuberculosis. Objectives: Our objective was to elucidate the impact of active tuberculosis survival on lung health in the Strong Heart Study (SHS), a population of American Indians historically highly impacted by tuberculosis. As arsenic exposure has also been related to lung function in the SHS, we also assessed the joint effect between arsenic exposure and past active tuberculosis. Methods: The SHS is an ongoing population-based, prospective study of cardiovascular disease and its risk factors in American Indian adults. This study uses tuberculosis data and spirometry data from the Visit 2 examination (1993-1995). Prior active tuberculosis was ascertained by a review of medical records. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC were measured by spirometry. An additional analysis was conducted to evaluate the potential association between active tuberculosis and arsenic exposure. Results: A history of active tuberculosis was associated with reduced percent predicted FVC and FEV1, an increased odds of airflow obstruction (odds ratio = 1.45, 95% confidence interval = 1.08-1.95), and spirometric restrictive pattern (odds ratio = 1.73, 95% confidence interval = 1.24-2.40). These associations persisted after adjustment for diabetes and other risk factors, including smoking. We also observed the presence of cough, phlegm, and exertional dyspnea after a history of active tuberculosis. In the additional analysis, increasing urinary arsenic concentrations were associated with decreasing lung function in those with a history of active tuberculosis, but a reduced odds of active tuberculosis was found with elevated arsenic.Conclusions: Our findings support existing knowledge that a history of active tuberculosis is a risk factor for long-term respiratory impairment. Arsenic exposure, although inversely associated with prior active tuberculosis, was associated with a further decrease in lung function among those with a prior active tuberculosis history. The possible interaction between arsenic and tuberculosis, as well as the reduced odds of tuberculosis associated with arsenic exposure, warrants further investigation, as many populations at risk of developing active tuberculosis are also exposed to arsenic-contaminated water.
Rationale: Permanent lung function impairment after active tuberculosis infection is relatively common. It remains unclear which spirometric pattern is most prevalent after tuberculosis. Objectives: Our objective was to elucidate the impact of active tuberculosis survival on lung health in the Strong Heart Study (SHS), a population of American Indians historically highly impacted by tuberculosis. As arsenic exposure has also been related to lung function in the SHS, we also assessed the joint effect between arsenic exposure and past active tuberculosis. Methods: The SHS is an ongoing population-based, prospective study of cardiovascular disease and its risk factors in American Indian adults. This study uses tuberculosis data and spirometry data from the Visit 2 examination (1993-1995). Prior active tuberculosis was ascertained by a review of medical records. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC were measured by spirometry. An additional analysis was conducted to evaluate the potential association between active tuberculosis and arsenic exposure. Results: A history of active tuberculosis was associated with reduced percent predicted FVC and FEV1, an increased odds of airflow obstruction (odds ratio = 1.45, 95% confidence interval = 1.08-1.95), and spirometric restrictive pattern (odds ratio = 1.73, 95% confidence interval = 1.24-2.40). These associations persisted after adjustment for diabetes and other risk factors, including smoking. We also observed the presence of cough, phlegm, and exertional dyspnea after a history of active tuberculosis. In the additional analysis, increasing urinary arsenic concentrations were associated with decreasing lung function in those with a history of active tuberculosis, but a reduced odds of active tuberculosis was found with elevated arsenic.Conclusions: Our findings support existing knowledge that a history of active tuberculosis is a risk factor for long-term respiratory impairment. Arsenic exposure, although inversely associated with prior active tuberculosis, was associated with a further decrease in lung function among those with a prior active tuberculosis history. The possible interaction between arsenic and tuberculosis, as well as the reduced odds of tuberculosis associated with arsenic exposure, warrants further investigation, as many populations at risk of developing active tuberculosis are also exposed to arsenic-contaminated water.
Entities:
Keywords:
American Indian; Strong Heart Study; arsenic; spirometry; tuberculosis
Authors: D N Guha Mazumder; Craig Steinmaus; Partha Bhattacharya; Ondine S von Ehrenstein; Nilima Ghosh; Michael Gotway; Arabinda Sil; John R Balmes; Reina Haque; Meera M Hira-Smith; Allan H Smith Journal: Epidemiology Date: 2005-11 Impact factor: 4.822
Authors: André F S Amaral; Sonia Coton; Bernet Kato; Wan C Tan; Michael Studnicka; Christer Janson; Thorarinn Gislason; David Mannino; Eric D Bateman; Sonia Buist; Peter G J Burney Journal: Eur Respir J Date: 2015-06-25 Impact factor: 16.671
Authors: Allan H Smith; Guillermo Marshall; Yan Yuan; Catterina Ferreccio; Jane Liaw; Ondine von Ehrenstein; Craig Steinmaus; Michael N Bates; Steve Selvin Journal: Environ Health Perspect Date: 2006-08 Impact factor: 9.031
Authors: Marisa Sobel; Ana Navas-Acien; Martha Powers; Maria Grau-Perez; Walter Goessler; Lyle G Best; Jason Umans; Elizabeth C Oelsner; Anna Podolanczuk; Tiffany R Sanchez Journal: Environ Res Date: 2021-10-13 Impact factor: 6.498
Authors: Arce Domingo-Relloso; Angela L Riffo-Campos; Martha Powers; Maria Tellez-Plaza; Karin Haack; Robert H Brown; Jason G Umans; M Daniele Fallin; Shelley A Cole; Ana Navas-Acien; Tiffany R Sanchez Journal: Clin Epigenetics Date: 2022-06-09 Impact factor: 7.259