Responses of susceptible subpopulations to nitrogen dioxide

This project was undertaken to investigate symptom responses and changes in the pulmonary function of two susceptible groups--people with asthma and people with chronic obstructive pulmonary disease (COPD)--when exposed to 0.3 parts per million (ppm) (560 micrograms/m3) nitrogen dioxide. In these controlled clinical studies, a double-blind crossover design with purified air in a 45-m3 environmental chamber was used. Groups of non-respiratory-impaired (normal) subjects of a comparable age range and of both genders constituted controls for the asthmatic and COPD groups. The exposure protocol required five days: day 1, training and base-line preexposure measurements; day 2, a first exposure to 0.3 ppm nitrogen dioxide or air in a randomized sequence; day 3, 24-hour follow-up measurements of possible delayed effects; day 4, a second exposure; and day 5, a second 24-hour postexposure follow-up. All four-hour exposures included several predetermined periods of exercise and pulmonary function measurements. To examine changes in bronchial responsiveness and to aid in subject selection, bronchial challenges with carbachol and isoproterenol aerosol were used. The project was undertaken in four phases, each lasting approximately one year. In the first year, 20 normal non-smoking volunteers (10 women and 10 men) with an average age of 31.0 years were assessed. The second year, 20 non-smoking subjects with mild to moderate asthma were evaluated. This group was comparable in gender and age to the control group of normal volunteers. The third year, 20 subjects with COPD were studied. This group had a mean age of 60.0 years and consisted of 13 men and seven women. All subjects had a history of smoking. During the fourth and final year of the study, a group of 20 elderly normal volunteers similar in age and gender to the COPD group were evaluated. The main findings of the study were as follows. No significant symptomatic or physiologic responses to nitrogen dioxide could be detected in either the young or the elderly control group. Prior studies of asthmatic subjects had led us to hypothesize that 0.3 ppm nitrogen dioxide is close to the minimum level needed to produce significant functional deficits during moderate activity in this susceptible group. However, in this study the asthmatic group as a whole did not manifest significant reductions in lung function after exposure to 0.3 ppm nitrogen dioxide compared to their preexposure base-line data or to their responses after a comparable four-hour exposure to air.(ABSTRACT TRUNCATED AT 400 WORDS)