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Asthma severity and susceptibility to air pollution
T J Hiltermann1, J Stolk, S C van der Zee
1Dept of Pulmonology, Leiden University Medical Centre, The Netherlands.
The European Respiratory Journal
|May 22, 1998
Summary
Asthma exacerbations are linked to air pollution, but asthma severity does not change sensitivity to ozone and PM10. This study found no difference in how air quality impacts patients with varying asthma severity.
Area of Science:
- Environmental Health
- Pulmonology
- Epidemiology
Background:
- Asthma exacerbations are frequently linked to exposure to ambient air pollutants like ozone and particulate matter (PM10).
- The influence of air pollution on asthma symptoms and medication use may vary based on asthma severity, although this has not been definitively established.
Purpose of the Study:
- To investigate whether the association between summertime air pollution (ozone and PM10) and acute respiratory symptoms, medication use, and peak expiratory flow differs among asthma patients grouped by severity.
- To evaluate the impact of air quality on asthma control in relation to individual asthma severity indicators such as airway hyperresponsiveness and inhaled corticosteroid use.
Main Methods:
- A panel of 60 non-smoking asthma patients, ranging from intermittent to severe persistent asthma, was monitored during the summer of 1995.
- Time series analysis was employed to assess associations between daily air pollutant levels (ozone, PM10, NO2, SO2, black smoke) and respiratory health parameters.
- Subgroup analyses were conducted based on pre-study indicators of asthma severity, including airway hyperresponsiveness and prior lung steroid use.
Main Results:
- A consistent positive association was observed between increased levels of ozone, PM10, black smoke, and nitrogen dioxide (NO2) and the prevalence of shortness of breath (maximal relative risk [RRmax] 1.18).
- Bronchodilator use also showed a significant association with elevated ozone and PM10 levels (RRmax 1.16).
- Stratifying patients by airway hyperresponsiveness or steroid use did not alter the observed associations, and no links were found with peak expiratory flow measurements.
Conclusions:
- The study concludes that asthma severity, as indicated by hyperresponsiveness or steroid use, does not appear to be a determining factor in patient sensitivity to ambient air pollution.
- Findings suggest that ozone and PM10 exposure are associated with increased respiratory symptoms and medication use across different asthma severity levels.