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，在第二次世界大战后不久，吸烟在澳大利亚男性中达到顶峰。既然这种吸烟流行的后果正在消失，我们就需要更多地关注导致这种情况的其他原因。拟议的研究将集中在老年人的职业和家庭暴露以及饮食因素上。长期以来，尘封的工作与慢性阻塞性肺病有关。然而，目前尚不清楚其他职业接触烟雾和蒸汽的程度。确定这类工作将导致更好的工作条件和预防进一步的病例。已经患有慢性阻塞性肺病的工人可以得到更公平的补偿。同样，如果发现室内接触烟草烟雾和无通风的燃气器具起作用，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病病例。一般认为肺气肿是由肺氧化应激和保护酶之间的不平衡引起的。富含抗氧化维生素和鱼类的饮食可以预防慢性阻塞性肺病的发展。如果这项研究得到证实，那么就有可能在有患慢性阻塞性肺病风险的吸烟者中进行补充剂的临床试验。公众营养教育可以减少未来的发病率。

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.