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Factors Associated with Persistent Lower Respiratory Symptoms or Asthma among Residents Exposed to a Sulphur Stockpile Fire Incident

1
Department of Environmental and Occupational Studies, Faculty of Applied Sciences, Cape Peninsula University of Technology (CPUT), Cape Town 7535, South Africa
2
Occupational Medicine Division and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Observatory 7925, South Africa
3
Emeritus Professor, Department of Chemical Engineering, Cape Peninsula University of Technology (CPUT), Cape Town 7535, South Africa
*
Author to whom correspondence should be addressed.
This author passed away prior to finalization of the manuscript.
Int. J. Environ. Res. Public Health 2019, 16(3), 438; https://doi.org/10.3390/ijerph16030438
Received: 2 November 2018 / Revised: 18 January 2019 / Accepted: 31 January 2019 / Published: 2 February 2019
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Abstract

Introduction: Residents of Macassar, South Africa, were exposed to sulphur dioxide vapours (SO2) caused by an ignited sulphur stockpile, which produced peak hourly SO2 levels of 20–200 ppm. The aim of this study was to assess the risk factors associated with persistent lower respiratory symptoms (LRS) or asthma six years after acute exposure to high SO2 levels. Methods: A case-control study of residents that presented for a health evaluation six years after the incident was conducted. Survey instruments included a questionnaire, clinical examination and medical record review by an expert panel. A “case” was defined as a resident with persistent LRS/asthma. The Industrial Source Complex Short Term Model (ISCST 3) was used to predict time-averaged hourly SO2 levels. Results: A previous history of pulmonary tuberculosis (PTB) was associated with persistent LRS/asthma (ORudj: 3.49, CI: 1.46–8.35). Cases were more likely to report chest tightness (ORudj: 9.93; CI: 5.15–19.11) at the time of the incident. Peak exposure at hour 15 was associated with persistent LRS/asthma (ORadj: 1.04; CI: 1.01–1.07). Conclusion: LRS/asthma persisted in some individuals six years after acute SO2 exposure. Aside from peak exposures, initial chest tightness and a previous history of PTB were the strong predictors of persistent LRS/asthma. View Full-Text
Keywords: persistent lower respiratory symptoms; asthma; exposure; sulphur dioxide persistent lower respiratory symptoms; asthma; exposure; sulphur dioxide
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Baatjies, R.; Adams, S.; Cairncross, E.; Omar, F.; Jeebhay, M.F. Factors Associated with Persistent Lower Respiratory Symptoms or Asthma among Residents Exposed to a Sulphur Stockpile Fire Incident. Int. J. Environ. Res. Public Health 2019, 16, 438.

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