nitrogen-dioxide and Cough

Topics: Air Pollution; Bronchitis; Child; Child, Preschool; Cough; Dust; Environmental Exposure; Humans; Nitrogen Dioxide; Respiration; Respiratory Tract Diseases; Rhinitis; Sulfur Dioxide

There is growing evidence that asthma symptoms can be aggravated or events triggered by exposure to indoor nitrogen dioxide (NO(2)) emitted from unflued gas heating. The impact of NO(2) on the respiratory health of children with asthma was explored as a secondary analysis of a randomised community trial, involving 409 households during the winter period in 2006 (June to September). Geometric mean indoor NO(2) levels were 11.4 μg · m(-3), while outdoor NO(2) levels were 7.4 μg · m(-3). Higher indoor NO(2) levels (per logged unit increase) were associated with greater daily reports of lower (mean ratio 14, 95% CI 1.12-1.16) and upper respiratory tract symptoms (mean ratio 1.03, 95% CI 1.00-1.05), more frequent cough and wheeze, and more frequent reliever use during the day, but had no effect on preventer use. Higher indoor NO(2) levels (per logged unit increase) were associated with a decrease in morning (-17.25 mL, 95% CI -27.63- -6.68) and evening (-13.21, 95% CI -26.03- -0.38) forced expiratory volume in 1 s readings. Outdoor NO(2) was not associated with respiratory tract symptoms, asthma symptoms, medication use or lung function measurements. These findings indicate that reducing NO(2) exposure indoors is important in improving the respiratory health of children with asthma.

Topics: Adolescent; Air Pollution, Indoor; Asthma; Child; Cough; Female; Humans; Male; Nitrogen Dioxide; Respiratory Function Tests; Respiratory Tract Infections; Seasons; Sneezing

A study of 4 comparable communities in central & northeastern Bombay (2 each) among randomly matched 349 subjects in 1988-9, along with ambient sulfur dioxide (SO2), Nitrogen dioxide (NO2) & suspended particulate matter (SPM) air monitoring was carried out. The levels in winter were higher particularly for SO2 in Parel (upto 584 micrograms) in Maravali; Deonar showed lower pollution. There were inter-area differences for housing, income, residential history but age-sex differences were small; these were reduced by matching. Clinical respiratory symptoms were higher in Parel & Maravali (cough 12% and 11.2%, dyspnoea 17% & 13.3% respectively). Cardiac problems are commoner in Parel (11.0%). Smoker had cough more often but not dyspnoea. Maravali had a high prevalence for headache and eye irritation (9.5%). Those using kerosene suffered more than those using gas (22.2% as compared to 9.2%) Lung functions (FVC, FEVI) were lowest in Parel for males and in Maravali for females. Expiratory flow rates were lower at Dadar and then at Maravali. Despite lower SO2 pollution, Maravali residents suffered equally as in Parel. This may be due to added effect of diesel exhausts (NO2, SPM) or other unmeasured chemicals.

Topics: Adolescent; Adult; Air Pollutants; Child; Cough; Female; Humans; India; Male; Middle Aged; Nitrogen Dioxide; Respiratory Tract Diseases; Seasons; Smoking; Sulfur Dioxide

Chronic respiratory symptoms involving bronchitis, cough and phlegm in children are underappreciated but pose a significant public health burden. Efforts for prevention and management could be supported by an understanding of the relative importance of determinants, including environmental exposures. Thus, we aim to develop a prediction model for bronchitic symptoms.. Schoolchildren from the population-based southern California Children's Health Study were visited annually from 2003 to 2012. Bronchitic symptoms over the prior 12 months were assessed by questionnaire. A gradient boosting model was fit using groups of risk factors (including traffic/air pollution exposures) for all children and by asthma status. Training data consisted of one observation per participant in a random study year (for 50% of participants). Validation data consisted of: (1) a random (later) year in the same participants (within-participant); (2) a random year in participants excluded from the training data (across-participant).. At baseline, 13.2% of children had asthma and 18.1% reported bronchitic symptoms. Models performed similarly within- and across-participant. Previous year symptoms/medication use provided much of the predictive ability (across-participant area under the receiver operating characteristic curve (AUC): 0.76 vs 0.78 for all risk factors, in all participants). Traffic/air pollution exposures added modestly to prediction as did body mass index percentile, age and parent stress.. Regardless of asthma status, previous symptoms were the most important predictors of current symptoms. Traffic/air pollution variables contribute modest predictive information, but impact large populations. Methods proposed here could be generalized to personalized exacerbation predictions in future longitudinal studies to support targeted prevention efforts.

Topics: Air Pollutants; Asthma; Bronchitis, Chronic; Child; Cough; Environmental Exposure; Female; Humans; Longitudinal Studies; Machine Learning; Male; Nitrogen Dioxide; Risk Factors; Surveys and Questionnaires

Childhood bronchitic symptoms are significant public and clinical health problems that produce a substantial burden of disease. Ambient air pollutants are important determinants of bronchitis occurrence.. To determine whether improvements in ambient air quality in Southern California were associated with reductions in bronchitic symptoms in children.. A longitudinal study involving 4602 children (age range, 5-18 years) from 3 cohorts was conducted during the 1993-2001, 1996-2004, and 2003-2012 years in 8 Southern California communities. A multilevel logistic model was used to estimate the association of changes in pollution levels with bronchitic symptoms.. Average concentrations of nitrogen dioxide, ozone, particulate matter with an aerodynamic diameter of less than 10 µm (PM10) and less than 2.5 µm (PM2.5).. Annual age-specific prevalence of bronchitic symptoms during the previous 12 months based on the parent's or child's report of a daily cough for 3 months in a row, congestion or phlegm other than when accompanied by a cold, or bronchitis.. The 3 cohorts included a total of 4602 children (mean age at baseline, 8.0 years; 2268 girls [49.3%]; 2081 Hispanic white [45.2%]) who had data from 2 or more annual questionnaires. Among these children, 892 (19.4%) had asthma at age 10 years. For nitrogen dioxide, the odds ratio (OR) for bronchitic symptoms among children with asthma at age 10 years was 0.79 (95% CI, 0.67-0.94) for a median reduction of 4.9 ppb, with absolute decrease in prevalence of 10.1%. For ozone, the OR was 0.66 (95% CI, 0.50-0.86) for a median reduction of 3.6 ppb, with an absolute decrease in prevalence of 16.3%. For PM10, the OR was 0.61 (95% CI, 0.48-0.78) for a median reduction of 5.8 µg/m3, with an absolute decrease in prevalence of 18.7%. For PM2.5, the OR was 0.68 (95% CI, 0.53-0.86) for a median reduction of 6.8 µg/m3, with absolute decrease in prevalence of 15.4%. Among children without asthma (n = 3710), the ORs were 0.84 (95% CI, 0.76-0.92) for nitrogen dioxide; 0.85 (95% CI, 0.74-0.97) for ozone, 0.80 (95% CI, 0.70-0.92) for PM10, and 0.79 (95% CI, 0.69-0.91) for PM2.5; with absolute decrease in prevalence of 1.8% for nitrogen dioxide, 1.7% for ozone, 2.2% for PM10, and 2.3% for PM2.5. The associations were similar or slightly stronger at age 15 years.. Decreases in ambient pollution levels were associated with statistically significant decreases in bronchitic symptoms in children. Although the study design does not establish causality, the findings support potential benefit of air pollution reduction on asthma control.

Topics: Adolescent; Age Factors; Air Pollutants; Air Pollution; Asthma; Bronchitis; California; Child; Child, Preschool; Cough; Environmental Monitoring; Female; Humans; Logistic Models; Longitudinal Studies; Male; Nitrogen Dioxide; Odds Ratio; Ozone; Particulate Matter; Prevalence; Time Factors

Information on potential cough triggers including environmental irritants is vital for successful management of chronic cough in patients. We investigated the relationship between ambient levels of particulate polycyclic aromatic hydrocarbons (PAH), nitrogen dioxide (NO₂) and sulphur dioxide (SO₂) exposures with cough prevalence. Eighty-three adult patients, who had been physician diagnosed with at least asthma, cough variant asthma and/or atopic cough, were divided into asthma and non-asthma groups. They recorded daily cough symptoms during 4 January-30 June 2011 study period while daily samples of total suspended particles were simultaneously collected by use of glass fiber filters and the particulate PAH content determined by high performance liquid chromatography coupled with a fluorescence detector. Ambient concentrations of NO₂ and SO₂ were obtained from a local monitoring site. Logistic regression models using generalized estimating equations were used to determine population-averaged estimates of association between cough prevalence and ambient pollutant exposures for the two groups. Fully adjusted odds ratios from single pollutant models were 1.083 (95% confidence interval (CI): 1.029, 1.140) and 1.097 (95% CI: 1.016, 1.185) per 0.57 ng/m³ for lag2 PAH exposure, while only for asthma group had significant associations with NO₂ and SO₂ exposures for both lag2 and lag02. Similar associations were observed in multipollutant models. This finding suggests that ambient PAH, NO₂, and SO₂ exposure even at low levels is related to cough prevalence in adult chronic cough patients and may be considered as aggravating factor during clinical management of the condition.

Topics: Adolescent; Adult; Air Pollutants; Asthma; Cough; Female; Humans; Japan; Logistic Models; Longitudinal Studies; Male; Nitrogen Dioxide; Odds Ratio; Polycyclic Aromatic Hydrocarbons; Prevalence; Sulfur Dioxide

The chronic health effects from exposure to ambient air pollution are still unclear. This study primarily aims to examine the relationship between long-term exposure to ambient air pollution and respiratory morbidities in Chinese children.. A cross-sectional study was conducted among 2,203 school children aged 8-10 in three districts with different air pollution levels in Hong Kong. Annual means for ambient PM10, SO2, NO2 and O3 in each district were used to estimate participants' individual exposure. Two questionnaires were used to collect children's respiratory morbidities and other potential risk factors. Multivariable logistic regression was fitted to estimate the risks of air pollution for respiratory morbidities.. Compared to those in the low-pollution district (LPD), girls in the high-pollution district (HPD) were at significantly higher risk for cough at night (ORadj. = 1.81, 95% CI: 1.71-2.78) and phlegm without colds (ORadj. = 3.84, 95% CI: 1.74-8.47). In addition, marginal significance was reached for elevated risks for asthma, wheezing symptoms, and phlegm without colds among boys in HPD (adjusted ORs: 1.71-2.82), as well as chronic cough among girls in HPD (ORadj. = 2.03, 95% CI: 0.88-4.70).. Results have confirmed certain adverse effects on children's respiratory health from long-term exposure to ambient air pollution. PM10 may be the most relevant pollutant with adverse effects on wheezing and phlegm in boys. Both PM10 and NO2 may be contributing to cough and phlegm in girls.

Topics: Air Pollution; Asthma; Child; Cough; Cross-Sectional Studies; Female; Hong Kong; Humans; Inhalation Exposure; Male; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Sounds; Respiratory Tract Diseases; Risk Factors; Sex Factors; Sulfur Dioxide; Surveys and Questionnaires

Ambient air pollution has been consistently associated with exacerbation of respiratory diseases in schoolchildren, but the role of early exposure to traffic-related air pollution in the first occurrence of respiratory symptoms and asthma is not yet clear.. We assessed the association between indexes of exposure to traffic-related air pollution during different periods of life and respiratory outcomes in a birth cohort of 672 newborns (Rome, Italy). Direct interviews of the mother were conducted at birth and at 6, 15 months, 4 and 7 years. Exposure to traffic-related air pollution was assessed for each residential address during the follow-up period using a Land-Use Regression model (LUR) for nitrogen dioxide (NO2) and a Geographic Information System (GIS) variable of proximity to high-traffic roads (HTR) (>10 000vehicles/day). We used age-specific NO2 levels to develop indices of exposure at birth, current, and lifetime time-weighted average. The association of NO2 and traffic proximity with respiratory disorders were evaluated using logistic regression in a longitudinal approach (Generalised Estimating Equation). The exposure indexes were used as continuous and categorical variables (cut-off points based on the 75th percentile for NO2 and the 25th percentile for distance from HTRs).. The average NO2 exposure level at birth was 37.2 μg/m(3) (SD 7.2, 10-90th range 29.2-46.1). There were no statistical significant associations between the exposure indices and the respiratory outcomes in the longitudinal model. The odds ratios for a 10-µg/m(3) increase in time-weighted average NO2 exposure were: asthma incidence OR=1.09; 95 CI% 0.78 to 1.52, wheezing OR=1.07; 95 CI% 0.90 to 1.28, shortness of breath with wheezing OR=1.16; 95 CI% 0.94 to 1.43, cough or phlegm apart from cold OR=1.11; 95 CI% 0.92 to 1.33, and otitis OR=1.08; 95 CI% 0.89 to 1.32. Stronger but not significant associations were found considering the 75th percentile of the NO2 distribution as a cut-off, especially for incidence of asthma and prevalence of wheeze (OR=1.41; 95 CI% 0.88 to 2.28 and OR=1.27; 95 CI% 0.95 to 1.70, respectively); the highest OR was found for wheezing (OR=2.29; 95 CI% 1.15 to 4.56) at the 7-year follow-up. No association was found with distance from HTRs.. Exposure to traffic-related air pollution is only weakly associated with respiratory symptoms in young children in the first 7 years of life.

Topics: Adult; Air Pollutants; Air Pollution; Asthma; Child; Child, Preschool; Cohort Studies; Cough; Dyspnea; Environmental Exposure; Environmental Monitoring; Female; Geographic Information Systems; Humans; Incidence; Infant; Infant, Newborn; Interviews as Topic; Logistic Models; Longitudinal Studies; Male; Nitrogen Dioxide; Odds Ratio; Otitis; Prevalence; Respiration Disorders; Respiratory Sounds; Rome; Vehicle Emissions

Air pollution has many negative health effects on the general population, especially children, subjects with underlying chronic disease and the elderly. The aims of this study were to evaluate the effects of traffic-related pollution on the exacerbation of asthma and development of respiratory infections in Italian children suffering from asthma or wheezing compared with healthy subjects and to estimate the association between incremental increases in principal pollutants and the incidence of respiratory symptoms.. This prospective study enrolled 777 children aged 2 to 18 years (375 with recurrent wheezing or asthma and 402 healthy subjects). Over 12 months, parents filled out a daily clinical diary to report information about respiratory symptoms, type of medication used and healthcare utilization. Clinical data were combined with the results obtained using an air pollution monitoring system of the five most common pollutants.. Among the 329 children with recurrent wheezing or asthma and 364 healthy subjects who completed follow-up, children with recurrent wheezing or asthma reported significantly more days of fever (p=0.005) and cough (p<0.001), episodes of rhinitis (p=0.04) and tracheitis (p=0.01), asthma attacks (p<0.001), episodes of pneumonia (p<0.001) and hospitalizations (p=0.02). In the wheezing/asthma cohort, living close to the street with a high traffic density was a risk factor for asthma exacerbations (odds ratio [OR]=1.79; 95% confidence interval [CI], 1.13-2.84), whereas living near green areas was found to be protective (OR=0.50; 95% CI, 0.31 -0.80). An increase of 10 μg/m3 of particulates less than 10 microns in diameter (PM10) and nitrogen dioxide (NO2) increased the onset of pneumonia only in wheezing/asthmatic children (continuous rate ratio [RR]=1.08, 95% CI: 1.00-1.17 for PM10; continuous RR=1.08, 95% CI: 1.01-1.17 for NO2).. There is a significant association between traffic-related pollution and the development of asthma exacerbations and respiratory infections in children born to atopic parents and in those suffering from recurrent wheezing or asthma. These findings suggest that environmental control may be crucial for respiratory health in children with underlying respiratory disease.

Topics: Adolescent; Air Pollution; Asthma; Automobiles; Child; Child, Preschool; Cough; Disease Progression; Female; Fever; Hospitalization; Humans; Italy; Male; Nitrogen Dioxide; Particulate Matter; Pneumonia; Prospective Studies; Residence Characteristics; Respiratory Sounds; Respiratory Tract Infections; Rhinitis; Risk Factors; Tracheitis

Topics: Adult; Air Pollution, Indoor; Chest Pain; Cough; Diagnosis, Differential; Dyspnea; Hemoptysis; Hockey; Humans; Inhalation Exposure; Lung Injury; Male; Nitrogen Dioxide; Time Factors; Young Adult

To investigate the long-term effects of air pollution on prevalence of respiratory symptoms in adults, in Beijing.. A cross-sectional study was conducted in an urban area and a suburban area with different levels of air pollution in October 2008, in Beijing. Respiratory symptoms were investigated by a standard questionnaire from the American Thoracic Society (ATS-DLD-78-A) in 9 052 adults who had lived there for at least two years. The concentrations of air pollutants for recent five years were obtained from Reports on the Quality of the Beijing Environment, Environmental Protection Bureau and Statistics Yearbook. The differences of the prevalence and standardized prevalence of respiratory symptoms in adults between the urban and suburban areas were analyzed by χ(2) test.. The standardized prevalences of persistent phlegm and asthma in urban adults were significantly higher than those in suburban adults [(3.06% vs. 2.43%, P<0.05) and (0.65% vs. 0.31%, P<0.01), respectively], but lower than that of the breathless (0.75% vs. 1.12%, P<0.05).. The study suggested that ambient air pollution had long-term effects on the prevalence of some respiratory symptoms in adults.

Topics: Adult; Air Pollutants; Asthma; China; Cities; Cough; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Particulate Matter; Prevalence; Sulfur Dioxide; Surveys and Questionnaires; Time Factors

Because their lungs and immune system are not completely developed, children are more susceptible to respiratory disease and more vulnerable to ambient pollution. We assessed the relation between prenatal and postnatal nitrogen dioxide (NO(2)) levels and the development of lower respiratory tract infections (LRTI), wheezing and persistent cough during the first year of life.. The study population consisted of 352 children from a birth cohort in Valencia, Spain. Prenatal exposure to NO(2), a marker of traffic related air pollution was measured at 93 sampling sites spread over the study area during four different sampling periods of 7 days each. It was modeled for each residential address through land use regression using the empirical measurements and data from geographic information systems. Postnatal exposure was measured once inside and outside each home using passive samplers for a period of 14 days. Outcomes studied were any episode of LRTI during the child's first year of life diagnosed by a doctor (bronchitis, bronchiolitis or pneumonia), wheezing (defined as whistling sounds coming from the chest), and persistent cough (more than three consecutive weeks). Outcomes and potential confounders were obtained from structured questionnaires. Multiple logistic regression was used to identify associations.. The cumulative incidence (CI) at first year of life was 30.4% for LRTI (23.0% bronchiolitis, 11.9% bronchitis and 1.4% pneumonia), 26.1% for wheezing and 6.3% for persistent cough. The adjusted odds ratio (95% confidence interval) per 10μg/m(3) increment in postnatal outdoor NO(2) concentration was 1.40 (1.02-1.92) for persistent cough. We also found some pattern of association with LRTI, bronchiolitis, bronchitis, wheezing and persistent cough in different prenatal periods, although it was not statistically significant.. Our results indicate that exposure to outdoor, but not indoor, NO(2) during the first year of life increases the risk of persistent cough.

Topics: Cough; Environmental Exposure; Female; Geographic Information Systems; Humans; Incidence; Infant; Logistic Models; Models, Theoretical; Nitrogen Dioxide; Pregnancy; Prenatal Exposure Delayed Effects; Respiratory Sounds; Respiratory Tract Infections; Spain; Surveys and Questionnaires; Vehicle Emissions

The objective of the study was to analyze the relationship between air pollutants and the prevalence of recent symptoms of asthma, allergic rhinitis, and atopic eczema in schoolchildren aged between 6 and 7 years.. The prevalence of recent (previous 12 months) symptoms of allergic diseases was obtained by means of the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC), Spain, with the participation of 7 centers (Asturias, Barcelona, Bilbao, Cartagena, La Coruña, Madrid, and Valencia) and 20 455 schoolchildren aged between 6 and 7 years, from 2002 to 2003. The pollutant detection systems of the aforementioned centers provided the mean annual concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and total suspended particulate matter.. The annual average concentration of SO2 showed a significant association with a higher prevalence of recent severe asthma (adjusted odds ratio [aOR] between level-1 and level-3 pollution, 1.32; 95% confidence interval [CI], 1.01-1.73), rhinitis (aOR, 1.56; 95% CI, 1.39-1.75), and rhinoconjunctivitis (aOR, 1.70; 95% CI, 1.45-2.00). The annual average concentration of CO was associated with a higher prevalence of rhinitis (aOR, 1.65; 95% CI, 1.34-2.04), rhinoconjunctivitis (aOR, 1.76; 95% CI, 1.31-2.37), and eczema (aOR, 1.55; 95% CI, 1.17-2.04). The annual average concentration for NO2 and total suspended particulate matter showed inverse associations with the prevalence of nocturnal dry cough.. Findings suggest that air pollutants such as SO2 and CO increase the risk of recent symptoms of asthma and allergic rhinitis in schoolchildren aged between 6 and 7 years in Spain.

Topics: Air Pollutants; Air Pollution; Asthma; Carbon Monoxide; Child; Cough; Dermatitis, Atopic; Female; Humans; Male; Meteorological Concepts; Nitrogen Dioxide; Particulate Matter; Prevalence; Respiratory Sounds; Rhinitis, Allergic, Perennial; Rhinitis, Allergic, Seasonal; Spain; Sulfur Dioxide; Urban Population

Topics: Air Pollutants; Attitude of Health Personnel; Child; Cohort Studies; Cough; Germany; Humans; Inhalation Exposure; Nitrates; Nitrogen Dioxide; Vehicle Emissions

Effects of nitrogen dioxide (NO2) on respiratory health have been the subject of extensive research. The outcomes of these studies were not consistent. Exposure to nitrous acid, which is a primary product of combustion, and is also formed when NO2 reacts with water, may play an important role in respiratory health. We estimate the independent effects of exposure to nitrogen dioxide and nitrous acid on respiratory symptoms during the first year of life.. Nitrogen dioxide and nitrous acid concentrations were measured once (1996-1998) in the homes of 768 infants who were at risk for developing asthma. Infants were living in southern New England. The frequency of respiratory symptoms in these children was recorded during the first year of life.. Infants living in homes with an NO2 concentration exceeding 17.4 ppb (highest quartile) had a higher frequency of days with wheeze (rate ratio = 2.2; 95% confidence interval = 1.4-3.4), persistent cough (1.8; 1.2-2.7), and shortness of breath (3.1; 1.8-5.6) when compared with infants in homes that had NO2 concentrations lower than 5.1 ppb (lowest quartile), controlling for nitrous acid concentration. Nitrous acid exposure was not independently associated with respiratory symptoms.. Among infants at risk for developing asthma, the frequency of reported respiratory symptoms in the first year of life was associated with levels of NO2 not currently considered to be harmful.

Topics: Air Pollution, Indoor; Asthma; Connecticut; Cough; Dyspnea; Environmental Exposure; Humans; Infant; Interviews as Topic; Massachusetts; Nitrogen Dioxide; Nitrous Acid; Respiration Disorders; Respiratory Sounds; Risk Assessment

In a cohort of 849 infants with an asthmatic sibling, the authors examined the relations of exposure to allergens (dust mite, cockroach, cat, and dog), nitrogen dioxide, and mold with symptoms of wheeze and persistent cough in the first year of life (1998-2000). Among infants whose mothers had physician-diagnosed asthma, neither dust mite allergen nor dog allergen was associated with either symptom. Exposure to cockroach allergen (Bla g 1 at >or=2 U/g) modestly increased the risk for wheeze (odds ratio (OR) = 1.87, 95% confidence interval (CI): 0.94, 3.71), and exposure to cat allergen modestly decreased the risk (OR = 0.60, 95% CI: 0.35, 1.03). Among infants of mothers with no asthma history, exposure to gas stoves (OR = 1.50, 95% CI: 1.05, 2.15) and wood-burning stoves (OR = 2.09, 95% CI: 1.12, 3.91) increased the risk of persistent cough. Similarly, measured nitrogen dioxide concentration was associated with persistent cough (OR = 1.21, 95% CI: 1.05, 1.40). Persistent mold affected both infants of mothers with asthma (for wheeze, OR = 2.27, 95% CI: 1.27, 4.07; for cough, OR = 1.83, 95% CI: 1.04, 3.22) and infants of mothers without asthma (for cough, OR = 1.55, 95% CI: 1.04, 2.31). Reported exposure was confirmed by an association of measured fungi with wheeze (OR = 1.23, 95% CI: 1.01, 1.49). This appears to have been the first study to measure all of these home exposures (indoor allergens, nitrogen dioxide, fungi) and to prospectively measure the frequency of infant wheeze and persistent cough.

Topics: Adult; Air Pollution, Indoor; Allergens; Asthma; Cohort Studies; Cough; Environmental Exposure; Female; Fungi; Humans; Infant; Infant, Newborn; Male; Nitrogen Dioxide; Odds Ratio; Respiratory Sounds; Risk Factors

To study possible chronic respiratory effects of air pollutants, we initiated a 10-yr prospective cohort study of Southern California children, with a study design focused on four pollutants: ozone, particulate matter, acids, and nitrogen dioxide (NO2). Twelve demographically similar communities were selected on the basis of historic monitoring information to represent extremes of exposure to one or more pollutants. In each community, about 150 public school students in grade 4, 75 in grade 7, and 75 in grade 10 were enrolled through their classrooms. Informed consent and written responses to surveys about students' lifetime residential histories, historic and current health status, residential characteristics, and physical activity were obtained with the help of the parents. In the first testing season, 3,676 students returned questionnaires. We confirmed associations previously reported between respiratory morbidity prevalence and the presence of personal, demographic, and residential risk factors. Rates of respiratory illness were higher for males, those living in houses with pets, pests, mildew, and water damage, those whose parents had asthma, and those living in houses with smokers. Wheeze prevalence was positively associated with levels of both acid (odds ratio [OR] = 1.45; 95% confidence interval [CI], 1.14-1.83) and NO2 (OR = 1.54; 95% CI, 1.08-2.19) in boys. We conclude, based on this cross-sectional assessment of questionnaire responses, that current levels of ambient air pollution in Southern California may be associated with effects on schoolchildren's respiratory morbidity as assessed by questionnaire.

Topics: Acids; Air Pollutants; Asthma; Bronchitis; California; Child; Chronic Disease; Cohort Studies; Cough; Female; Humans; Male; Nitrogen Dioxide; Ozone; Prevalence; Prospective Studies; Respiratory Sounds; Respiratory Tract Diseases; Surveys and Questionnaires

To identify characteristics associated with respiratory symptoms due to an episode of air pollution.. Mail survey.. In October 1992, the population of the city of Winnipeg was exposed to elevated levels of particulate matter (total and <10 microm size), carbon monoxide, nitrogen dioxide, and volatile organic compounds due to smoke from adjacent fields where farmers were burning agricultural residue (straw and stubble).. We surveyed 428 participants in the ongoing Lung Health Study (35 to 64 years old, both sexes) with mild to moderate airways obstruction (mean FEV1 percent predicted 73+/-12%), and a high level of airways hyperreactivity (23% of men and 37% of women).. While 37% of subjects were not bothered by smoke at all, 42% reported that symptoms (cough, wheezing, chest tightness, shortness of breath) developed or became worse due to the air pollution episode and 20% reported that they had breathing trouble. Those with symptoms were more likely to be female than male and were more likely to be ex-smokers than smokers. Subjects with asthma and chronic bronchitis were also more likely affected. The degree of airways obstruction and the level of bronchial hyperresponsiveness were not associated with increased susceptibility.. Gender, smoking habit, and respiratory symptoms but not bronchial hyperresponsiveness or the degree of airways obstruction are factors influencing susceptibility to symptoms due to air pollution in adult smokers and former smokers.

Topics: Adult; Agriculture; Air Pollutants; Air Pollution; Airway Obstruction; Asthma; Bronchial Hyperreactivity; Bronchitis; Carbon Monoxide; Chest Pain; Chronic Disease; Cough; Disease Susceptibility; Dyspnea; Female; Forced Expiratory Volume; Humans; Male; Manitoba; Middle Aged; Nitrogen Dioxide; Organic Chemicals; Respiration; Respiratory Sounds; Sex Factors; Smoke; Smoking

Nitrogen dioxide levels were measured in 80 homes in the Latrobe Valley, Victoria, Australia, using passive samplers. Some 148 children between 7 and 14 yr of age were recruited as study participants, 53 of whom had asthma. Health outcomes for the children were studied using a respiratory questionnaire, skin prick tests, and peak flow measurements. Nitrogen dioxide concentrations were low, with an indoor median of 11.6 microgram/m3 (6.0 ppb), and a maximum of 246 microgram/m3 (128 ppb). Respiratory symptoms were more common in children exposed to a gas stove (odds ratio 2.3 [95% CI 1. 0-5.2], adjusted for parental allergy, parental asthma, and sex). Nitrogen dioxide exposure was a marginal risk factor for respiratory symptoms, with a dose-response association present (p = 0.09). Gas stove exposure was a significant risk factor for respiratory symptoms even after adjusting for nitrogen dioxide levels (odds ratio 2.2 [1.0-4.8]), suggesting an additional risk apart from the average nitrogen dioxide exposure associated with gas stove use. Atopic children tended to have a greater risk of respiratory symptoms compared with nonatopic children with exposure to gas stoves or nitrogen dioxide, but the difference was not significant.

Topics: Adolescent; Air Pollutants; Air Pollution, Indoor; Asthma; Child; Confidence Intervals; Cough; Dyspnea; Female; Fossil Fuels; Household Articles; Housing; Humans; Hypersensitivity; Male; Nitrogen Dioxide; Odds Ratio; Oxidants, Photochemical; Parents; Peak Expiratory Flow Rate; Respiration Disorders; Respiratory Sounds; Risk Factors; Sex Factors; Skin Tests; Surveys and Questionnaires

Bronchial hyperresponsiveness (BHR) and peak expiratory flow (PEF) variability are associated expressions of airway lability, yet probably reflect different underlying pathophysiologic mechanisms. We investigated whether both measures can be used interchangeably to identify subjects who are susceptible to ambient air pollution. Data on BHR (>= 20% fall in FEV1), PEF variability (ampl%mean PEF > 5% on any day during an 8-d period with low air pollution levels) and diary data on upper and lower respiratory symptoms, cough, and phlegm were collected in 189 subjects (48-73 yr). The acute effects (lag0) of particulate matter with a diameter less than 10 micrometers (PM10), black smoke, SO2 and NO2 on the prevalence of symptoms were estimated with logistic regression. In subjects with airway lability, both when expressed as PEF variability (69%) and BHR (28%), the prevalence of symptoms increased significantly with increasing levels of air pollution, especially in those with the greater PEF variability (n = 55, 29%). We found no such consistent positive associations in adults without airway lability. PEF variability, and to a smaller extent BHR, can be used to identify adults who are susceptible to air pollution. Though odds ratios were rather low (ranging from 1.13 to 1.41), the impact on public health can be substantial because it applies to large populations.

Topics: Acute Disease; Adult; Air Pollutants; Air Pollution; Bronchial Hyperreactivity; Cough; Disease Susceptibility; Female; Forced Expiratory Volume; Humans; Logistic Models; Male; Middle Aged; Nitrogen Dioxide; Odds Ratio; Particle Size; Peak Expiratory Flow Rate; Prevalence; Public Health; Respiratory Tract Diseases; Rural Health; Smoke; Sputum; Sulfur Dioxide; Urban Health

In 1994, 16,187 junior high school students were surveyed in Jakarta and surrounding cities, Indonesia, to study the effect of air pollution on respiratory illnesses. Nitrogen dioxide (NO2) was measured by the filter badge developed by Yanagisawa and Nishimura as a measure of air pollution. The average concentration of NO2 is the highest in central Jakarta and Tangerang (22-30 ppb), the lowest in rural areas (5-11 ppb), and in other cities, 11-20 ppb. Self-administered questionnaires were given to the students in 29 schools to obtain respiratory symptoms of cough, phlegm and wheeze. A significant relationship was found in this study between NO2 exposure levels and prevalence rates of cough, phlegm, and wheezing without cold, which were 27.7 to 38.7%, 15.0 to 21.9%, and 1.4 to 2.9%, respectively. Prevalence rates of persistent cough and persistent phlegm were 7.3 to 10.8% and 4.5 to 5.0% respectively. These rates were higher than those found by other researchers. This difference may be partly due to the survey methods. The more polluted, the higher the prevalence rate of respiratory symptoms.

Topics: Adolescent; Air Pollution; Cough; Female; Humans; Indonesia; Male; Nitrogen Dioxide; Prevalence; Respiration Disorders; Respiratory Sounds

A daily diary of respiratory symptoms was collected from the parents of 1,844 school children in six U.S. cities to study the association between ambient air pollution exposures and respiratory illness. A cohort of approximately 300 elementary school children in each of six communities were asked to keep a daily log of the study child's respiratory symptoms for one year. Daily measurements of ambient sulfur dioxide, nitrogen dioxide, ozone, inhalable particles (PM10), respirable particles (PM2.5), light scattering, and sulfate particles were made, along with integrated 24-h measures of aerosol strong acidity. The analyses were limited to the five warm season months between April and August. Significant associations were found between incidence of coughing symptoms and incidence of lower respiratory symptoms and PM10, and a marginally significant association between upper respiratory symptoms and PM10. There was no evidence that other measures of particulate pollution including aerosol acidity were preferable to PM10 in predicting incidence of respiratory symptoms. Significant associations in single pollutant models were also found between sulfur dioxide or ozone and incidence of cough, and between sulfur dioxide and incidence of lower respiratory symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Acute Disease; Air Pollutants; Child; Cohort Studies; Cough; Humans; Hydrogen-Ion Concentration; Nitrogen Dioxide; Odds Ratio; Ozone; Respiratory Tract Diseases; Seasons; Sulfur Dioxide; Temperature

In epidemiological studies for an environmental risk assessment, doses are often observed with errors. However, they have received little attention in data analysis. This paper studies the effect of measurement errors on the observed dose-response curve. Under the assumptions of the monotone likelihood ratio on errors and a monotone increasing dose-response curve, it is verified that the slope of the observed dose-response curve is likely to be gentler than the true one. The observed variance of responses are not so homogeneous as to be expected under models without errors. The estimation of parameters in a hockey-stick type dose-response curve with a threshold is considered on line of the maximum likelihood method for a functional relationship model. Numerical examples adaptable to the data in a 1986 study of the effect of air pollution that was conducted in Japan are also presented. The proposed model is proved to be suitable to the data in the example cited in this paper.

Topics: Air Pollutants; Bias; Cough; Cross-Sectional Studies; Dose-Response Relationship, Drug; Dose-Response Relationship, Radiation; Humans; Japan; Likelihood Functions; Male; Nitrogen Dioxide

Seven adult male healthy volunteer subjects were exposed to 0.15 ppm each of O3, SO2 and NO2 alone and in combination, with intermittent light exercise for two hours. Three of the 7 subjects developed cough during deep inspiration and one subject had chest pain during exposure to O3 alone. Among the various indices of pulmonary function tests, specific airway conductane (Gaw/Vtg) was the most sensitive index to examine the changes produced by the exposure to O3 and other pollutants. Significant decrease of Gaw/Vtg in comparison with control measurements was observed in 6 of 7 subjects during exposure to O3 alone, and in all subjects during exposures to the mixture of O3 and other pollutants. However, no significant enhancement of effect was observed in the mixture of O3 and other pollutants, although a slightly greater decrease of Gaw/Vtg was observed for the mixture of O3 and other pollutants than for O3 alone.

Topics: Adult; Air Pollutants; Cough; Humans; Male; Nitrogen Dioxide; Ozone; Physical Exertion; Respiration; Respiratory Function Tests; Sulfur Dioxide

Twenty-four men were refueling a missile when a large spill of oxidizer occurred. Three crewmen were exposed to very high concentrations of the oxides of nitrogen. One died within minutes. Severe respiratory distress syndrome developed in the other two, one of whom survived. Twenty-one other workers were exposed to minimal to moderate concentrations of the gas. Most remained asymptomatic while six had shortness of breath, cough, or hemoptysis. The three with persistent symptoms received corticosteroid therapy; the complaints resolved in two. Corticosteroid therapy for four asymptomatic patients who had moderate hypoxemia two weeks after the accident may have aborted the second stage of nitrogen dioxide injury. Six patients with minimal exposure had persisting headaches, visual disturbances, and emotional difficulties. These latter findings may represent an unusual complication of exposure to these gases.

Topics: Accidents, Occupational; Adult; Cough; Environmental Exposure; Headache; Hemoptysis; Humans; Hypoxia; Male; Neurologic Manifestations; Nitrogen Dioxide; Respiratory Distress Syndrome; Time Factors

Topics: Adolescent; Air Pollution; California; Carbon Monoxide; Cough; Differential Threshold; Dose-Response Relationship, Drug; Environmental Exposure; Epidemiologic Methods; Female; Headache; Humans; Male; Morbidity; Nitrogen Dioxide; Oxidation-Reduction; Students, Nursing; Temperature; Thoracic Diseases; Weather

Topics: Air Pollution; Bronchitis; California; Carbon Monoxide; Cough; Dust; Environmental Exposure; Expectorants; Female; Humans; Hydrocarbons; Male; Middle Aged; Nitric Oxide; Nitrogen Dioxide; Respiratory Tract Diseases; Sex Factors; Smoking; Social Class; Spirometry; Sulfur Dioxide; Time Factors; Vital Capacity