Risk factors for asthma, chronic bronchitis and emphysema in older adults

慢性阻塞性肺病(包括慢性支气管炎和肺气肿)是澳大利亚的一个主要公共卫生问题。已知的主要原因是吸烟，澳大利亚男性吸烟在第二次世界大战后不久达到顶峰。现在这种吸烟流行病的后果已经过去，需要更多地关注导致这种疾病的其他原因。这项拟议的研究将侧重于老年人的职业和家庭暴露以及饮食因素。长期以来，尘土飞扬的工作一直与慢性阻塞性肺病联系在一起。然而，尚不清楚其他职业接触烟雾和蒸气的程度也有多大。确定这类工作将带来更好的工作条件，并防止进一步的案件发生。已经患上慢性阻塞性肺病的工人可以得到更公平的补偿。同样，如果发现室内暴露于烟草烟雾和未通风的气体用具起到了一定作用，那么进一步控制吸烟、烟道和改善通风也可以预防慢性阻塞性肺疾病。人们普遍认为，肺气肿是由于肺部氧化应激和保护酶之间的失衡造成的。富含抗氧化维生素和鱼类的饮食可以预防慢性阻塞性肺疾病的发展。如果这项研究证实了这一点，那么就有可能对有患COPD风险的吸烟者进行补充剂的临床试验。公众营养教育可以减少未来这种情况的发生。

Chronic obstructive pulmonary disease (including chronic bronchitis and emphysema) is a major public health problem in Australia. The main known cause is cigarette smoking, which peaked among Australian men shortly after the second world war. Now that the consequences of this epidemic of smoking are passing, more attention needs to be paid to other causes of the condition. The proposed study will focus on occupational and domestic exposures and dietary factors in older people. Dusty jobs have long been associated with COPD. However it is not known to what extent other occupational exposures to fumes and vapours are also responsible. Identifying such jobs would lead to better workplace conditions and prevention of further cases. Workers who have already developed COPD could be more fairly compensated. Similarly if indoor exposures to tobacco smoke and unvented gas appliances were found to play a role, further controls on smoking, flues and improved ventilation could also prevent cases of COPD. It is generally thought that emphysema develops from an imbalance between the oxidative stresses on the lungs and protective enzymes. A diet high in antioxidant vitamins and fish may protect against the development of COPD. If confirmed by this study, it would then be possible to conduct clinical trials of supplementation in smokers at risk of developing COPD. Public nutritional education could reduce the incidence of the condition in the future.