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Gender Differences in the Association of Individual and Contextual Exposures with Lung Function in a Rural Canadian Population

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Abstract

Introduction

To investigate the association of individual and contextual exposures with lung function by gender in rural-dwelling Canadians.

Methods

A cross-sectional mail survey obtained completed questionnaires on exposures from 8263 individuals; a sub-sample of 1609 individuals (762 men, 847 women) additionally participated in clinical lung function testing. The three dependent variables were forced expired volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. Independent variables included smoking, waist circumference, body mass index, indoor household exposures (secondhand smoke, dampness, mold, musty odor), occupational exposures (grain dust, pesticides, livestock, farm residence), and socioeconomic status. The primary analysis was multiple linear regression, conducted separately for each outcome. The potential modifying influence of gender was tested in multivariable models using product terms between gender and each independent variable.

Results

High-risk waist circumference was related to reduced FVC and FEV1 for both genders, but the effect was more pronounced in men. Greater pack-years smoking was associated with lower lung function values. Exposure to household smoke was related to reduced FEV1, and exposure to livestock, with increased FEV1. Lower income adequacy was associated with reduced FVC and FEV1.

Conclusion

High-risk waist circumference was more strongly associated with reduced lung function in men than women. Longitudinal research combined with rigorous exposure assessment is needed to clarify how sex and gender interact to impact lung function in rural populations.

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Notes

  1. For brevity sake, we use the term gender throughout the rest of the paper; however, we recognize that the effects of sex and gender on human health are complexly interwoven throughout the life course [19].

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Acknowledgments

The Saskatchewan Rural Health Study Team consists of James Dosman, MD (Designated Principal Investigator, University of Saskatchewan, Saskatoon, SK Canada); Dr. Punam Pahwa, PhD (Co-principal Investigator, University of Saskatchewan, Saskatoon SK Canada); Dr. John Gordon, PhD (Co-principal Investigator, University of Saskatchewan, Saskatoon SK Canada); Yue Chen, PhD (University of Ottawa, Ottawa Canada); Roland Dyck, MD (University of Saskatchewan, Saskatoon SK Canada); Louise Hagel (Project Manager, University of Saskatchewan Saskatoon SK Canada); Bonnie Janzen, PhD (University of Saskatchewan, Saskatoon SK Canada); Chandima Karunanayake, PhD (University of Saskatchewan, Saskatoon SK Canada); Shelley Kirychuk, PhD (University of Saskatchewan, Saskatoon SK Canada); Niels Koehncke, MD (University of Saskatchewan, Saskatoon SK Canada); Joshua Lawson, PhD, (University of Saskatchewan, Saskatoon SK Canada); William Pickett, PhD (Queen’s University, Kingston ON Canada); Roger Pitbaldo, PhD (Professor Emeritus, Laurentian University, Sudbury ON Canada); Donna Rennie, RN, PhD, (University of Saskatchewan, Saskatoon SK Canada); and Ambikaipakan Senthilselvan, PhD (University of Alberta, Edmonton, AB, Canada). We are grateful for the contributions of the rural municipality administrators and the community leaders of the towns included in the study that facilitated access to the study populations and to all of participants who donated their time to complete and return the survey.

Funding

Canadian Institutes of Health Research MOP-187209-POP-CCAA-11829.

Author information

Authors and Affiliations

  1. Department of Community Health & Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Road, Saskatoon, SK, S7N-5E5, Canada

    Bonnie Janzen & Punam Pahwa

  2. Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada

    Chandima Karunanayake, Donna Rennie, Joshua Lawson, Shelley Kirychuk, Louise Hagel, Niels Koehncke, James Dosman & Punam Pahwa

  3. College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada

    Donna Rennie

  4. Department of Public Health Sciences, Queens University, Kingston, ON, Canada

    William Pickett

  5. Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada

    Joshua Lawson

  6. School of Public Health, University of Alberta, Edmonton, AB, Canada

    Ambikaipakan Senthilselvan

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  1. Bonnie Janzen
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  2. Chandima Karunanayake
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  5. Joshua Lawson
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  9. Niels Koehncke
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  10. James Dosman
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  11. Punam Pahwa
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Consortia

for the Saskatchewan Rural Health Study Team

  • James Dosman
  • , Punam Pahwa
  • , John Gordon
  • , Yue Chen
  • , Roland Dyck
  • , Louise Hagel
  • , Bonnie Janzen
  • , Chandima Karunanayake
  • , Shelley Kirychuk
  • , Niels Koehncke
  • , Joshua Lawson
  • , William Pickett
  • , Roger Pitbaldo
  • , Donna Rennie
  •  & Ambikaipakan Senthilselvan

Corresponding author

Correspondence to Bonnie Janzen.

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Conflicts of Interest

None.

Additional information

The Saskatchewan Rural Health Study Team are listed in “Acknowledgments.”

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Janzen, B., Karunanayake, C., Rennie, D. et al. Gender Differences in the Association of Individual and Contextual Exposures with Lung Function in a Rural Canadian Population. Lung 195, 43–52 (2017). https://doi.org/10.1007/s00408-016-9950-8

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  • DOI: https://doi.org/10.1007/s00408-016-9950-8

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