The effects of ambient NO2 on lung function in primary schoolchildren

The effect of ambient NO2 on lung function was investigated in a sample of 423 schoolchildren. At each of four locations NO2 was monitored continuously. Over a 6-month period from January to June 1990 two surveys were performed and spirometry recorded each time for each child. Linear regression was used to estimate the effect of NO2 for different time intervals preceding lung function testing. A decrease of NO2 between surveys was significantly associated with a higher forced vital capacity (FVC) at the second survey. For each microgram/m3 NO2 decrease the model predicted an increase in FVC of 1.5 ml [for the 2-hr mean (P < 0.05)] and 3.1 ml [for the 12-hr mean (P < 0.01)]. We conclude that even at NO2 levels below current air-quality standards children demonstrate significant changes in lung function.

[Bronchial hyperreactivity to distilled water]

For an epidemiological study 446 children were challenged with distilled water. The protocol consisted of 10 minutes tidal inhalation of an ultrasonically nebulized aerosol of distilled water. For children presenting with a clinical diagnosis of asthma the odds ratio for a positive challenge test was 9.1 compared to non-asthmatics [95% confidence intervals: 2.4-34.9; p = 0.001]. Symptoms cough (p = 0.03), cough at night (p = 0.03) and atopy defined by prick-test (p = 0.001) were also significantly associated with a positive challenge. The easy conduct of our protocol, the--from a pathophysiological point of view--"close to asthma" stimulus, and the small number of side-effects, indicate that the challenge with distilled water can be regarded as an alternative to metacholine provocation testing.

Oral contraceptives and human papillomavirus infection in cervical intraepithelial neoplasia

We report about 142 patients from whom colposcopically directed cervical punch biopsies were taken which showed condylomatous lesions with or without cervical intraepithelial neoplasia (CIN). Fifty-six (39.4%) of these women used oral contraceptives (OC) for at least two years before examination. We used DNA in situ hybridization on all biopsies for detection of human papillomavirus (HPV)-DNA. Among OC users a significant trend towards higher HPV infection rates in high grade CIN (odds ratio 2.9, P less than 0.05) was found, whereas non-users of oral contraceptives had the highest HPV infection rate in condylomatous lesions without CIN (odds ratio 0.5, P less than 0.05). Thus in OC users HPV infection was about 24 times more likely in CIN III as in condyloma, while among non-users the trend was the other way round (7-fold likelihood of HPV positivity in condyloma compared to CIN III). Other known risk factors for cervical carcinoma did not influence HPV infection rates in either group.

Determinants of airway response to challenge with distilled water in a population sample of children aged 7 to 10 years old

We challenged 446 schoolchildren and measured the percent decrease in FEV1 following 10 min of tidal inhalation of UNDW. Assessment tools for respiratory symptoms and atopy were questionnaire and skin testing, respectively. A previous diagnosis of asthma was most strongly associated with a positive airway response (defined as a fall in FEV1 greater than or equal to 10 percent. A positive response was also associated with atopy, presence of cough, cough during night, or any respiratory symptom. A child's age and the prechallenge FEF75% also explained response to distilled water indicating less responsiveness for older children and those with relative greater airway diameter. For the previous diagnosis of asthma, a positive distilled water challenge test had a sensitivity of 36 percent and a specificity of 92 percent. We conclude that a significant relationship between airway response to distilled water, asthma and symptoms suggestive for asthma exists for a childhood population sample.

Psychological health, self-reported physical health and health service use. Risk differential observed after one year of unemployment

One year after the closure of a furniture factory the health consequences of long-term unemployment were studied among the 215 former employees and an interviewer-administered questionnaire was used to measure psychological health, self-perceived physical health and health service use. Those remaining unemployed 12 months after the closure were found to be 8 times more likely to report poor psychological health than were the re-employed (Odds ratio (OR): 8.5; 95% CI: 4.2-17.0). Self-reported physical ill-health was generally thought be respondents to be due to former work (56 percent of all disorders were related by subjects to former work history) and was also found to be associated with current employment status (OR 5.6; 95% CI: 2.7-11.5). Health services were over-utilized by the unemployed (OR 2.2; 95% CI: 1.2-4.1) and this differential was demonstrated to be even greater for the older and those reporting more diseases. Given the increasing proportion of long term unemployed in many Western countries this health service over-utilization will impose a substantial burden on public health expenditures unless other means of psychological and social support are provided.

[Effects of traffic-induced emissions on the pediatric respiratory tract]

The aim of this study was to investigate the relationship between paediatric pulmonary function and air pollution. For this purpose, 511 primary schoolchildren (mean age 9 years) from areas with different emission data in Austria were submitted to pulmonary function testing every 2 months in the period 1987/1988. Emission data were provided for NO2, SO2, and O3 by permanent measuring stations for the whole of the period under observation. Statistical analysis using the Mantel-Henzel procedure revealed an independent significantly significant effect of NO2 concentration 2 to 6 hours before the function test on the prevalence of obstructive function.