Low-yield Cigarettes And Diminution Of Small Airways Lung Function In Long-term Smokers
Funder
National Health and Medical Research Council
Funding Amount
$209,500.00
Summary
The modern cigarette has been designed to produce low yields of tar when the tobacco in the cigarette is burnt. The tar contains human carcinogens, and monitoring and regulating yields of tar has long been part of the comprehensive tobacco control strategy in Australia. This focus on tar has given an implicit endorsement of the low-yield cigarette as a safer cigarette. Recently, however, controversy has emerged about whether smoking low-yield cigarettes has reduced the harm done by smoking. The ....The modern cigarette has been designed to produce low yields of tar when the tobacco in the cigarette is burnt. The tar contains human carcinogens, and monitoring and regulating yields of tar has long been part of the comprehensive tobacco control strategy in Australia. This focus on tar has given an implicit endorsement of the low-yield cigarette as a safer cigarette. Recently, however, controversy has emerged about whether smoking low-yield cigarettes has reduced the harm done by smoking. The concern is that adenocarcinoma of the lung, a type of lung cancer that is most common in the small peripheral airways, has increased in frequency. This could be because the low-yield cigarette, with reduced yields of nicotine as well as tar, is smoked more intensely by smokers to compensate for the low nicotine. By smoking more intensely, we mean taking larger and more frequent puffs, inhaling the smoke deeply into the lungs, and holding the breath before expiring. This method of smoking would result in more tar particles being deposited in the peripheries of the lung where adenocarcinoma is most common. Because cigarette smoking has been linked also with other structural changes in the small airways of the lung, resulting in obstruction of airflow, we will test whether smoking low-yield cigarettes is associated with greater obstruction of the small airways than is smoking higher-yield cigarettes. To test whether the mechanism is the method of smoking, we will carefully describe and quantify each subject's pattern of smoking including the deposition of smoke-like Technegas particles in the peripheral lung.Read moreRead less
A Randomised Controlled Trial Investigating The Respiratory Effects Of Nitrogen Dioxide In Schoolchildren
Funder
National Health and Medical Research Council
Funding Amount
$212,189.00
Summary
Research has shown that exposures to air pollutants such as nitrogen dioxide (NO2), sulphur dioxide, ozone and respirable particulate matter less than 10 microns are associated with respiratory symptoms. Unlike the other air pollutants nitrogen dioxide is an indoor gas which occurs in higher concentrations than outdoors in households which cook or heat with gas. Recent research has demonstrated that NO2 at concentrations easily achieved indoors can increase respiratory illness, particularly in c ....Research has shown that exposures to air pollutants such as nitrogen dioxide (NO2), sulphur dioxide, ozone and respirable particulate matter less than 10 microns are associated with respiratory symptoms. Unlike the other air pollutants nitrogen dioxide is an indoor gas which occurs in higher concentrations than outdoors in households which cook or heat with gas. Recent research has demonstrated that NO2 at concentrations easily achieved indoors can increase respiratory illness, particularly in children and asthmatics. In South Australia we have the opportunity to demonstrate health effects of NO2 on children with asthma more conclusively, as a high number of schools heat their classrooms with unflued gas heaters which produce high NO2. In the proposed study, half of the primary schools with unflued gas heaters will have these heaters replaced with heaters which do not emit NO2. This process of selecting schools will be performed at random and in the school holidays, so as not to bias the children in regard to their exposure status. Additionally, only asthmatic children without gas appliances at home will be included. Asthma symptoms and lung function measurements will be collected in order to determine any differences in the health outcomes of both groups. The results of this study will be able to give conclusive information on health effects related to NO2, that will substantially contribute to the development of a recommended NO2 guideline. This is of worldwide interest.Read moreRead less
Risk Factors For Chronic Respiratory Diseases In Middle Age: 36-year Follow-up Of The Tasmanian Asthma Study
Funder
National Health and Medical Research Council
Funding Amount
$358,750.00
Summary
This project will improve our understanding of the causes of chronic respiratory diseases (CRDs) in adults. CRDs are clearly a major public health problem, but there are no good data on the natural history and risk factors for these diseases. Regular follow-up through childhood to adulthood is the best method to examine these factors, but such data is lacking due to difficulties in conducting long-term studies. The Tasmanian Asthma Study (TAS), based on 8,585 Tasmanians (i.e. probands) born in 1 ....This project will improve our understanding of the causes of chronic respiratory diseases (CRDs) in adults. CRDs are clearly a major public health problem, but there are no good data on the natural history and risk factors for these diseases. Regular follow-up through childhood to adulthood is the best method to examine these factors, but such data is lacking due to difficulties in conducting long-term studies. The Tasmanian Asthma Study (TAS), based on 8,585 Tasmanians (i.e. probands) born in 1961, is one of the worlds most important resources of such information. The probands, their parents (16,267) and siblings (21,044) were first investigated for respiratory problems in 1968. Subsequently, three follow-up surveys were carried out at ages 13 (1974), 20 (1981) and 31 (1992) on either the total or sub-samples of the probands. In 1992, the children and spouses of the probands were also surveyed. Information on all respiratory problems was collected in all the follow-ups, although the main focus of the TAS to date has been asthma. The probands are now reaching the age at which all CRD as a group are beginning to inflict an increasing disease burden, which will become greater in the next two decades. Hence, TAS now provides an ideal opportunity to examine the potential risk factors and natural history of and of CRDs using data collected to date and new data collected at age 43. Also, it will provide a platform for future studies to investigate the progression of CRDs in this cohort. Hence, we propose to carry out the 36 year follow-up of this cohort focusing on CRDs. This will provide important information for preventing chronic respiratory morbidity and disability in the future, which will be original and significant not only in Australia but also internationally.Read moreRead less
Epidemiology Of Middle-age BHR: A Prospective Study From Childhood To Middle Age
Funder
National Health and Medical Research Council
Funding Amount
$593,840.00
Summary
Increased airway reactivity (BHR) in middle-age increases the risk of chronic respiratory diseases (CRDs) in old age, which are recognised as a major public health problem. Knowledge on the causes of these conditions is currently limited. This project will improve our understanding of the childhood and adult causes of increased reactivity of the airways in middle-age. Such knowledge will help in identifying preventive strategies for middle age BHR and thereby CRDs in old age.
Trials To Prevent The Transmission And Complications Of Sexually Transmitted Infections, Including HIV
Funder
National Health and Medical Research Council
Funding Amount
$306,123.00
Summary
Sexually transmitted infections (STIs) are important causes of illness in some sectors of the community. Even though they can be effectively prevented and treated, many health services do not give them priority. This research project will study ways in which general practitioners can better diagnose and treat STIs. We will carry out trials that compare new approaches to supporting doctors in this area, that involve a mixture of training, reminders and technical support as needed.
This study will follow up over 12,000 men aged 65-83 years who have previously completed a questionnaire about their medical, social, family and occupational history and lifestyle and have undergone a simple physical examination (height, weight, waist, girth at the hips and blood pressure). The first aim is to determine which of these factors predicts serious ill-health from heart disease, stroke and certain cancers in old age. In addition, we will test the hypothesis that risk factors for heart ....This study will follow up over 12,000 men aged 65-83 years who have previously completed a questionnaire about their medical, social, family and occupational history and lifestyle and have undergone a simple physical examination (height, weight, waist, girth at the hips and blood pressure). The first aim is to determine which of these factors predicts serious ill-health from heart disease, stroke and certain cancers in old age. In addition, we will test the hypothesis that risk factors for heart disease also predict the development of dementia because it seems that part of dementia in some patients is explained by their having suffered multiple small strokes. Finally, we will examine the relationship between development of dementia and previous major surgery as there is growing evidence that major surgical operations in older patients can be followed by confusion and impairment of thinking that may never recover fully. The overall aim is to discover preventable factors for several of the leading causes of ill-health in old age.Read moreRead less
Metabolic Syndrome, Inflammation And Non-alcoholic Fatty Liver Disease In Busselton
Funder
National Health and Medical Research Council
Funding Amount
$351,300.00
Summary
The metabolic syndrome is a clustering of obesity, insulin resistance, high cholesterol and high blood pressure. It could affect up to 30% of the population and often leads to diabetes and heart disease. Fatty liver disease is a chronic liver condition that often has no symptoms but can lead to serious liver damage. It could affect up to 25% of the population and is common even in people who drink very little alcohol. The rising prevalence of obesity in Australia suggests that the metabolic synd ....The metabolic syndrome is a clustering of obesity, insulin resistance, high cholesterol and high blood pressure. It could affect up to 30% of the population and often leads to diabetes and heart disease. Fatty liver disease is a chronic liver condition that often has no symptoms but can lead to serious liver damage. It could affect up to 25% of the population and is common even in people who drink very little alcohol. The rising prevalence of obesity in Australia suggests that the metabolic syndrome and fatty liver disease may be on the increase and therefore so too could diabetes and heart disease which already consume significant health resources. Using the unique health data collection of the Busselton Health Study in Western Australia, this project will help to determine how common these conditions are in Australia and lead to a better understanding of the nature and causes of these conditions including the possible role of chronic inflammation. This important information will be used to provide opportunities for better risk assessment, disease prevention, and earlier intervention.Read moreRead less
The Real And Changing Atherothrombotic Disease Burden And Secondary Prevention
Funder
National Health and Medical Research Council
Funding Amount
$507,387.00
Summary
Absolute numbers of Australians with diseased narrowed blood vessels in the heart, brain or leg are increasing, dominating health priorities and expenditure. By linking Department of Health datasets, without identifying individual's, trends in hospital admissions, prescription of chronic protective medications and the cost consequences to the health system among and across conditions will be determined. The findings will provide quality measures of hospital care and inform quality improvement