title: Peak expiratory flow variability, bronchial responsiveness, and susceptibility to ambient air pollution in adults.
abstract: 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.
authors.affiliation: Departments of Epidemiology and Statistics, University of Groningen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Boezen
authors.forename: J
authors.initials: J
authors.lastname: Schouten
authors.forename: B
authors.initials: B
authors.lastname: Rijcken
authors.forename: J
authors.initials: J
authors.lastname: Vonk
authors.forename: J
authors.initials: J
authors.lastname: Gerritsen
authors.forename: S
authors.initials: S
authors.lastname: van der Zee
authors.forename: G
authors.initials: G
authors.lastname: Hoek
authors.forename: B
authors.initials: B
authors.lastname: Brunekreef
authors.forename: D
authors.initials: D
authors.lastname: Postma
mesh_terms: D000208:Acute Disease; D000328:Adult; D000393:Air Pollutants / Q000009:adverse effects; D000397:Air Pollution / Q000009:adverse effects*; D016535:Bronchial Hyperreactivity / Q000503:physiopathology*; D003371:Cough / Q000503:physiopathology; D004198:Disease Susceptibility; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009585:Nitrogen Dioxide / Q000009:adverse effects; D016017:Odds Ratio; D010316:Particle Size; D010366:Peak Expiratory Flow Rate / Q000502:physiology*; D015995:Prevalence; D011634:Public Health; D012140:Respiratory Tract Diseases / Q000209:etiology* / Q000503:physiopathology; D012423:Rural Health; D012906:Smoke / Q000009:adverse effects; D013183:Sputum / Q000378:metabolism; D013458:Sulfur Dioxide / Q000009:adverse effects; D014504:Urban Health
chemical_list: D000393:Air Pollutants; D012906:Smoke; D013458:Sulfur Dioxide; D009585:Nitrogen Dioxide