慢性阻塞性肺疾病(COPD)是一种阻塞性气道疾病，其特征是用力呼气量在一秒钟内(FEV1)缓慢渐进且不可逆转地减少，并伴有肺气肿和慢性支气管炎(Rabe et al. 2007;Cazzola等，2015);在正常人群中，肺功能随着年龄的增长而下降(Ito和Barnes, 2009)。尽管遗传率为40-77%，但许多其他因素也会加剧这种情况(Young et al.， 2009)。而慢性阻塞性肺病的开发和发展涉及多个基因,基因基因和基因-环境交互作用(一个½idzik et al . 2008;de Jong et al. 2015)。吸烟被认为是慢性阻塞性肺病(Chan-Yeung et al. 2007;(Kurmi et al.2015)轻度和中度COPD患者在10年内发生肺癌的风险是正常吸烟者的3倍，而重度COPD患者发生肺癌的风险是正常吸烟者的10倍(El-Zein et al. 2012)。然而，在从不吸烟的人群中也存在着与copd相关的肺癌死亡率的增加(Turner等，2007;Kiri等2010;奥尔德里奇et al.2015)。尽管采石和采矿活动是诱发慢性阻塞性肺病的重要职业设置(Jhoncy等，2011;(Iftikhar et al. 2009)，但对慢性阻塞性肺病相关文献的研究并未关注这种职业病的工作场所识别。慢性阻塞性肺病的预后也存在不确定性，尽管存在一些经过验证的指标(Briggs et al. 2008)。由于这些指标需要患者的投入和护理人员/医生的解释，这些指标可能无法满足现场疾病识别的需要。本研究采用推荐肺活量学评价(Briggs et al. 2008;Shiota et al. 2015)进行现场疾病识别，以识别碎石单元(粉尘暴露)的COPD病例。在工作场所进行这样的鉴定变得很重要，因为50-80%的慢性阻塞性肺病是基于误诊/共流诊断而漏诊的，原因是依赖于报告的症状不够敏感和/或由于没有人向卫生提供者报告.
澳洲护理学论文代写:吸烟的危害
Chronic Obstructive Pulmonary Disease (COPD) is an obstructive airway disorder characterized by the slowly progressive and irreversible decrease in forced expiratory volume in one second (FEV1), accompanied by emphysema and chronic bronchitis (Rabe et al. 2007; Cazzola et al. 2015); it develops with decreasing lung function as a function of age in the normal population (Ito and Barnes, 2009). Despite the heritability of 40-77%, a host of other influences can also exacerbate this condition (Young et al., 2009). Rather the development and progression of COPD involves multiple genes, gene-gene and gene-environment interactions (Židzik et al. 2008; de Jong et al. 2015). Smoking exposure is considered as the most important risk factor for the development of COPD (Chan-Yeung et al. 2007; Kurmi et al.2015) with mild and moderate COPD cases having a three- fold risk of developing lung cancer within ten years, which increases to a ten-fold risk with severe COPD compared to the smokers with normal lung function (El-Zein et al. 2012). There also however exists COPD-associated increased mortality from lung cancer in non-ever smokers (Turner et al. 2007; Kiri et al. 2010; Aldrich et al.2015).Despite quarrying and mining activities as important occupational set-ups inducing COPD (Jhoncy et al. 2011; Iftikhar et al. 2009), yet work-place identification of this occupational disease has not come to attention on pursuing literature related to COPD. Also there is uncertainty in prognosis of COPD although a number of validated indices exist (Briggs et al. 2008). As these indices require in-puts from patients and the interpretation by the care-giver/physician, these may not be able to cater to disease-identification in the field. In the present study, the on-site disease-identification using the recommended spirometry evaluation (Briggs et al. 2008;Shiota et al. 2015) to recognize COPD cases at stone-crushing units (dust exposure) was carried out. Such an identification at the workplace gains importance as 50-80% of COPD are missed-out on the basis of misdiagnosis/co-current diagnosis due to relying on reported symptoms which are not sufficiently sensitive and / or because of failure of persons to report to the health provider