Abstract
OBJECTIVES—To determine whether associations might be found, in patients with chronic airflow obstruction, between symptoms, peak flow rate (PEF), and particle mass and numbers, and to assess which measure was most closely associated with changes in health. Epidemiological studies have shown associations between particulate air pollution and cardiovascular and respiratory disease, and it has been proposed that these may be mediated by particles of nm size (ultrafine). METHODS—Relations were investigated between symptom scores, PEF, and bronchodilator use in 44 patients aged ⩾50 years with chronic obstructive pulmonary disease, and daily measurements of both mass of ambient particles of aerodynamic diameter less than 10 µm (PM10) and numbers of ultrafine particles (<100 nm), allowing for meteorological variables. Symptom scores, bronchodilator use, and PEF were recorded daily for 3 months. Counts of ultrafine particles were made by the TSI model 3934 scanning mobility particle sizer (SMPS) and PM10 measurements by the tapered element oscillating microbalance (TEOM). RESULTS—Ultrafine particle counts indoors and outdoors were significantly correlated, those indoors being about half of those outdoors. No associations were found between actual PEF and PM10 or ultrafine particles. However, there was a 19% increase in the rate of 10% decrements in daytime PEF with increases in PM10 from 10 to 20 µg/m3 which was of borderline significance (p=0.05). A change in PM10 from 10 to 20 µg/m3 was significantly associated with a 14% increase in the rate of high scores of shortness of breath (p=0.003). A similar change in PM10 as a moving average of the same day and 2 previous days was associated with a 31% increase in the rate of high scores for cough (p=0.02). Cough symptoms were also associated with lower temperatures (p=0.02). Higher use of medicines was also associated with higher PM10, but the increases were very small in clinical terms. CONCLUSIONS—Evidence was not found to support the hypothesis that the component of particulate pollution responsible for effects on respiratory symptoms or function resides in the fraction below 100 nm diameter. The consistent associations between symptoms and PM10 suggest that a contribution of the coarser fraction should not be dismissed. Further studies will be needed before the conclusions of this specific project may be generalised. Keywords: air pollution; ultrafine particles; chronic obstructive lung disease
Full Text
The Full Text of this article is available as a PDF (139.9 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Anderson H. R., Limb E. S., Bland J. M., Ponce de Leon A., Strachan D. P., Bower J. S. Health effects of an air pollution episode in London, December 1991. Thorax. 1995 Nov;50(11):1188–1193. doi: 10.1136/thx.50.11.1188. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Carrothers T. J., Evans J. S. Assessing the impact of differential measurement error on estimates of fine particle mortality. J Air Waste Manag Assoc. 2000 Jan;50(1):65–74. doi: 10.1080/10473289.2000.10463988. [DOI] [PubMed] [Google Scholar]
- DURBIN J., WATSON G. S. Testing for serial correlation in least squares regression. I. Biometrika. 1950 Dec;37(3-4):409–428. [PubMed] [Google Scholar]
- Ferin J., Oberdörster G., Penney D. P. Pulmonary retention of ultrafine and fine particles in rats. Am J Respir Cell Mol Biol. 1992 May;6(5):535–542. doi: 10.1165/ajrcmb/6.5.535. [DOI] [PubMed] [Google Scholar]
- Hoek G., Dockery D. W., Pope A., Neas L., Roemer W., Brunekreef B. Association between PM10 and decrements in peak expiratory flow rates in children: reanalysis of data from five panel studies. Eur Respir J. 1998 Jun;11(6):1307–1311. doi: 10.1183/09031936.98.11061307. [DOI] [PubMed] [Google Scholar]
- Oberdorster G., Gelein R. M., Ferin J., Weiss B. Association of particulate air pollution and acute mortality: involvement of ultrafine particles? Inhal Toxicol. 1995 Jan-Feb;7(1):111–124. doi: 10.3109/08958379509014275. [DOI] [PubMed] [Google Scholar]
- Pekkanen J., Timonen K. L., Ruuskanen J., Reponen A., Mirme A. Effects of ultrafine and fine particles in urban air on peak expiratory flow among children with asthmatic symptoms. Environ Res. 1997;74(1):24–33. doi: 10.1006/enrs.1997.3750. [DOI] [PubMed] [Google Scholar]
- Peters A., Wichmann H. E., Tuch T., Heinrich J., Heyder J. Respiratory effects are associated with the number of ultrafine particles. Am J Respir Crit Care Med. 1997 Apr;155(4):1376–1383. doi: 10.1164/ajrccm.155.4.9105082. [DOI] [PubMed] [Google Scholar]
- Pope C. A., 3rd, Dockery D. W. Acute health effects of PM10 pollution on symptomatic and asymptomatic children. Am Rev Respir Dis. 1992 May;145(5):1123–1128. doi: 10.1164/ajrccm/145.5.1123. [DOI] [PubMed] [Google Scholar]
- Pope C. A., 3rd, Dockery D. W., Spengler J. D., Raizenne M. E. Respiratory health and PM10 pollution. A daily time series analysis. Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):668–674. doi: 10.1164/ajrccm/144.3_Pt_1.668. [DOI] [PubMed] [Google Scholar]
- Seaton A., MacNee W., Donaldson K., Godden D. Particulate air pollution and acute health effects. Lancet. 1995 Jan 21;345(8943):176–178. doi: 10.1016/s0140-6736(95)90173-6. [DOI] [PubMed] [Google Scholar]
- Seaton A., Soutar A., Crawford V., Elton R., McNerlan S., Cherrie J., Watt M., Agius R., Stout R. Particulate air pollution and the blood. Thorax. 1999 Nov;54(11):1027–1032. doi: 10.1136/thx.54.11.1027. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tiittanen P., Timonen K. L., Ruuskanen J., Mirme A., Pekkanen J. Fine particulate air pollution, resuspended road dust and respiratory health among symptomatic children. Eur Respir J. 1999 Feb;13(2):266–273. doi: 10.1034/j.1399-3003.1999.13b08.x. [DOI] [PubMed] [Google Scholar]
- Timonen K. L., Pekkanen J. Air pollution and respiratory health among children with asthmatic or cough symptoms. Am J Respir Crit Care Med. 1997 Aug;156(2 Pt 1):546–552. doi: 10.1164/ajrccm.156.2.9608044. [DOI] [PubMed] [Google Scholar]
- Watt M., Godden D., Cherrie J., Seaton A. Individual exposure to particulate air pollution and its relevance to thresholds for health effects: a study of traffic wardens. Occup Environ Med. 1995 Dec;52(12):790–792. doi: 10.1136/oem.52.12.790. [DOI] [PMC free article] [PubMed] [Google Scholar]