Characterization of Occupational Endotoxin-Related Small Airway Disease With Longitudinal Paired Inspiratory/Expiratory ct Scans.

Details

• Alternative Title:
  Chest, 2025, v. 168, no. 1: Characterization of Occupational Endotoxin-Related Small Airway Disease With Longitudinal Paired Inspiratory/Expiratory ct Scans.
• Journal Article:
  Chest
• Personal Author:
  Sun, Yuming ; Kang, Jian ; Zhang, Feng-ying ; Wang, Hantao ; Lai, Peggy S. ; Washko, George R. ; Estepar, Raul San Jose ; Christiani, David C. ; Li, Yi
• Description:
  Although small airway disease (SAD) has been recognized as a major contributor to obstructive respiratory diseases, the association between occupational endotoxin exposure and SAD, as characterized by CT scans, requires further investigation.
  
  What is the association between occupational endotoxin exposure and SAD, and which CT imaging biomarkers effectively detect preclinical airway dysfunction?
  
  This study included 404 patients from the Shanghai Textile Workers Cohort. We collected longitudinal inspiratory/expiratory CT scans, spirometry data, and endotoxin levels in 2011 and 2016. We evaluated the marginal association among endotoxin, small airway measures, and spirometry by Pearson correlation coefficient. We applied linear mixed models and linear regression models to understand the adjusted association among endotoxin, small airway measures, and spirometry.
  
  We found significant association between endotoxin and SAD and airflow obstruction, as quantified by small airway measures and spirometry, respectively. All small airway measures were marginally correlated with endotoxin, among which relative volume change in voxels with attenuation between -856 Hounsfield units (HU) and -950 HU (RVC
  
  ) and residuals from the linear regression of Exp
  
  on the percentage of voxels with attenuation less than -950 HU (Residual
  
  ) showed the strongest positive correlations. Percent predicted FEV
  
  (pp FEV
  
  ) showed the strongest negative correlation with endotoxin. After adjusting for confounders, the expiratory-to-inspiratory ratio of mean lung attenuation (E/I MLA), RVC
  
  , Residual
  
  , FEV
  
  , and pp FEV
  
  yielded a significant association with endotoxin. Workers who were exposed to 1,500 to 2,300 EU/m
  
  endotoxin showed a significantly higher RVC
  
  by 0.071 (P = .006) and a 8.57% lower pp FEV
  
  (P = .007) compared with workers exposed to less than 50 EU/m
  
  endotoxin.
  
  We found that occupational endotoxin exposure was significantly associated with SAD and lower FEV
  
  . We identified Residual
  
  and E/I MLA as the imaging biomarkers for early detection of small airway dysfunction in preclinical individuals (FEV
  
  /FVC ≥ 0.70). These findings have important implications for identifying early-stage SAD and airflow obstruction with CT imaging biomarkers.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Male
  • Endotoxins
  • Tomography, X-Ray Computed
  • Female
  • Middle Aged
  • Occupational Exposure
  • Spirometry
  • Adult
  • Occupational Diseases
  More +
• Keywords:
  • imaging biomarkers
  • occupational endotoxin exposure
  • paired CT scans
  • small airway disease
• Source:
  Chest, 2025, v. 168, no. 1
• DOI:
  https://doi.org/10.1016/j.chest.2024.12.037
• ISSN:
  0012-3692 ; 1931-3543
• Pubmed ID:
  39832623
• Pubmed Central ID:
  PMC12245607
• Document Type:
  Text
• Funding:
  R01 CA249096/CA/NCI NIH HHSUnited States/ ; R01 CA269398/CA/NCI NIH HHSUnited States/ ; R01 OH002421/OH/NIOSH CDC HHSUnited States/ ; T42 OH008416/OH/NIOSH CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  China
• Pages in Document:
  43-55 (23 pdf pages)
• Volume:
  168
• Issue:
  1
• Download URL:
  https://stacks.cdc.gov/view/cdc/261754/cdc_261754_DS1.pdf
• File Type:
  [PDF - 576.53 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:f972b479580da7e356f0279e1561c2a0057bf0c4b47f66355f6c36be04dd4a06ad12a5b66873001b8357ceafd24587eae565401806cf55fba17a066015687193