AIR POLLUTION AND ITS HEALTH EFFECTS IN JAPAN

Reference Values for Peak Expiratory Flow Rate in Adults of African Descent

Substantial racial differences in the values of peak expiratory flow (PEF) rate have been noted by several workers in the past. It has also been noted that applying prediction formulae derived from a Caucasian population overestimated the PEF values in Black Africans by 12%–15%. Yet reference values used up until the present, even among Black populations, are based on such formulae. This study provides new reference values for use in the Black population. They were obtained by using curvilinear formulae derived from the study of 1009 normal adult Nigerians (668 men and 341 women) between the ages of 15 years and 82 years, living and/or working in Port Harcourt, Nigeria and its hinterland.

Physical Function Traits of Long-term Officially Acknowledged Victims of Pollution-related Illnesses Compared with Elderly Patients with Chronic Obstructive Pulmonary Disease

[Purpose] To examine the long-term effects of air pollution on the physical functioning of a group of officially acknowledged victims of pollution-related illnesses (Victims group) who were exposed to air pollution more than 50 years ago, we compared them with age-matched patients with chronic obstructive pulmonary disease (COPD group). [Subjects and Methods] The Victims group comprised 34 subjects and the COPD group 24, all of whom were aged over 65 years. Respiratory function, muscle strength, exercise capacity and physical activity were measured and compared between the groups. [Results] The Victims group had significantly higher forced expiratory volume in the first second (FEV1), proportion of predicted FEV1, proportion of predicted vital capacity (VC), and ratio of FEV1 to forced VC than the COPD group. Surprisingly, the muscle strength of the Victims group was significantly weaker, their incremental shuttle walking test distance was significantly shorter, and their physical activity was significantly less than those of the COPD group. [Conclusion] Although the pulmonary function of Victims was better than that of the COPD group, their physical functioning was worse. Exposure to air pollution 50 years ago appears to continue to adversely affect their physical function. It is particularly important to offer Victims rehabilitation to improve their exercise performance and physical activity.

Effects of air pollution on children's pulmonary function in urban and suburban areas of Wuhan, People's Republic of China

In May and June of 1988, the spirometric lung function of 604 children, who were aged 7-13 y and who were free of chronic respiratory conditions, was measured in the urban core and a suburb of Wuhan, China. During 1981-1988, ambient total suspended particulate (TSP) levels averaged 481 micrograms/m3 in the urban core and 167 micrograms/m3 in the suburb. In 1988, TSP levels, measured within 500 m of the children's homes, averaged 251 micrograms/m3 in the urban core and 110 micrograms/m3 in the suburb. Levels of sulfur dioxide and nitrogen oxides were also higher in the urban core. Proportions of families who burned coal and gas domestically were similar in both areas. In linear and logarithmic regression models, height was a stronger determinant of forced vital capacity and forced expiratory volume in 1 s than was age or weight. In linear models, the proportion of variance explained by height (R-squared) ranged from 0.54 for urban females' forced expiratory volume in 1 s to 0.77 for suburban males and females. Both forced vital capacity and forced expiratory volume in 1 s were consistently lower in urban than suburban children. The average forced vital capacity and forced expiratory volume in 1 s in children 132-144 cm tall were 6.7% and 3.8% lower, respectively, in the urban core than the suburb; suburban-urban differences increased with height. Suburban-urban differences in slopes of lung function growth curves were statistically significant for forced vital capacity but not for forced expiratory volume in 1 s. Rates of clinical upper respiratory irritation were also generally elevated in urban children. These results strongly suggest that urban ambient air pollution exposure in China contributes to retardation in the growth of children's lung function. Confirmatory longitudinal studies are in progress in Wuhan and three other Chinese cities.

Cross-sectional and longitudinal changes in pulmonary function associated with automobile pollution among bridge and tunnel officers

This study investigated the effects of emissions from the internal combustion engine on pulmonary function and respiratory symptoms in men collecting tolls and directing traffic in areas with high levels of air pollution. Bridge and tunnel officers (BTOs) were administered pulmonary function tests and respiratory questionnaires for up to 11 consecutive years (n = 944). Carboxyhemoglobin levels were also measured. Regression coefficients on year tested were calculated on 466 individuals (49% of all BTOs) tested at least 3 years. The tunnel workers had significantly lower FEV1S (forced expiratory volume at one second) and FVCs (forced vital capacity), respiratory symptoms, and higher carboxyhemoglobin levels than the bridge workers. BTOs working over 20 years had the lowest mean pulmonary function values, the steepest slopes, and the most respiratory symptoms. We believe that the data show an association between working as a bridge and tunnel officer and decreased pulmonary function and increased respiratory symptoms, but it was not readily evident whether the effects were of clinical importance.

Changes in lung function of children after an air pollution decrease

Forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1.0), forced expiratory flow between 25 and 75% of FVC (FEF25-75), and maximal expiratory flow at 50% of FVC (MEF50) were measured in 1,880 school children who lived in urban areas before and after a decrease of air pollution. A group of 162 children from a suburban area served as controls. In the first survey, FEV1.0, FEF25-75, and MEF50 of children from urban areas were significantly lower, while in the second survey they were not significantly different from those of controls. The slopes over time of FEV1.0, FEF25-75, and MEF50, adjusted for sex and anthropometric variables, were closely related to the decrease of pollutants concentration. Our results suggest that a decrease of air pollution may produce an improvement of lung function.

The effects of air pollution on the respiratory health of children: a cross-sectional study

To investigate the effects of air pollution on the respiratory health of children, a subject of some controversy, a comparative study was undertaken of 2,385 school children who lived in central urban, peripheral urban, and suburban areas. Daily monitoring of sulphur dioxide and total suspended particle concentrations in all areas showed that pollutant concentrations in central and peripheral urban areas were above commonly accepted safety levels for respiratory health, while concentrations in the suburban area were within acceptable limits. A questionnaire administered to each mother assessed environmental exposure to pollutants in the household, the occurrence of respiratory symptoms as well as lung diseases as diagnosed by a physician, and general information. Children were interviewed about smoking habits and any acute respiratory symptoms. Children also performed standard lung function tests. Results showed that children from both urban areas had lessened pulmonary function and a higher prevalence of bronchial secretion with common colds than did those from the suburban area. These differences persisted after corrections for exposure to indoor pollutants, active or passive smoking, socioeconomic status, and sex. Parental cigarette smoking was related to a fall in forced expiratory volume in 1 second and an increased incidence of acute respiratory illnesses and chronic cough in children. Although boys had higher lung volumes and lower air flow, regression analysis showed no significant influence of the interactions "sex-geographic area" and "sex-smoking" on lung function. It was concluded that air pollution has a significant effect on the respiratory health of children.

The University of Akron study on air pollution and human health effects I. Methodology, baseline data, and aerometrics

This study determined the health effects of ambient air pollutants in two grade school populations in Akron, Ohio. One school is adjacent to industry and has elevated levels of sulfur dioxide (SO2) and moderate levels of nitrogen dioxide (NO2), while the other school is 4 km east and unpolluted. This study was designed in this manner for two purposes: (1) to identify and monitor ambient levels of air pollutants in an area proximal to the grade school so that the levels could be accurately assessed, and (2) to determine baseline pulmonary function values and questionnaire responses from the parents indicating any acute and/or chronic respiratory problem in the child. Ninety-five percent of the children enrolled in this study liver within 2 km of the schools and aerometric stations, thus providing for careful control in the study design. The results of this study indicate that SO2 and NO2 levels are significantly higher in the school adjacent to industry. Although pulmonary function data were not significantly different between schools, the frequency of questionnaire responses to acute and chronic pulmonary problems was greater in the children at the school adjacent to industry. The data tend to indicate early pulmonary effects of air pollution in children living adjacent to industry and exposed to elevated levels of SO2 and NO2. We suggest that additional longitudinal work that carefully monitors total suspended particulates, NO2, SO2, and health data should be conducted to confirm these results.

Air pollution and COPD

Air pollution referable to increased ambient levels of sulfur dioxide and suspended particulates is associated with increased episodes of acute bronchitis and is also causally related to some cases of chronic bronchitis. Oxidant air pollution is associated with abnormalities of pulmonary function in children and is a major contributory factor in COP, especially bronchitis, in some areas of the United States. The relationship of nitrogen dioxide atmospheric contamination to COPD is still controversial. In our opinion, the epidemiologic studies conducted to date have been inadequate and further elucidation is indicated. Cadmium fumes and compounds have been found to be instrumental in the development of some cases of chronic bronchitis and emphysema in Sweden. This association is unproved in the United States and warrants a thorough clinical and epidemiologic evaluation.

Mucociliary transport in chickens infected with Newcastle disease virus and exposed to sulfur dioxide

Mucociliary transport was studied in the nasal mucous membranes and sinuses of 3-week-old chickens which were either exposed to sulfur dioxide (SO2), infected intranasally with the mesogenic strain of Newcastle disease virus (NDV), or exposed to SO2 after NDV infection. A newly developed apparatus was used to follow intranasal transport rates over time in the same animal, and to follow sinus transport rates over time in a separate group of animals. Intermittent exposure to concentrations of 1.4-66.0 ppm SO2 produced peaks of increased intranasal transport time, with intervening recovery periods. This suggests a homeostatic mechanism. Transport was also decelerated in the sinus when concentrations of SO2 were above 10 ppm. NDV infection produced decelerated intranasal transport rates but did not decelerate sinus rates. Combined NDV and SO2 interacted to produced persistent deceleration of the intransal transport rate. In the sinus, the combination seemed to conteract the decelerating effect of SO2 alone, suggesting a separate mechanism of homeostasis.

Sulfur dioxide and tracheobronchial clearance in man

Tracheobronchial clearance was measured in nine healthy, nonsmoking adults. Technetium Tc 99m albumin aerosol (mass median diameter, 3 mu; geometric standard deviation, 1.6) was inhaled as a bolus under controlled conditions to achieve reproducible deposition in large airways. Each subject was studied in three seperate three-hour experiments: twice under control conditions and once exposed to 5 ppm sulfur dioxide (pollutant exposure after aerosol inhalation). Lung retention of activity was measured using a gamma camera interfaced to a data storage and retrieval system. The study showed that (1) Both deposition and clearance were highly reproducible in individuals in repeat control studies. (2) Acute exposure to 5 ppm sulfur dioxide had no significant effect (P greater than .05) on mucocillary clearance in resting healthy subjects, except perhaps for a small transient change (P=.05) after one hour. (3) Pulmonary function tests showed a decrease in maximal midexpiratory flow (P less than .01) but no other significant changes.

Peak flow rate in Nigeria: anthropometric determinants and usefulness in assessment of ventilatory function

The inexpensive nature of the peak flow rate (PFR) makes it a suitable test of ventilatory function for use in some parts of Africa, where medical facilities are still poor. In order to establish standard values for PFR in Nigeria, anthropometric measurements, lung volumes, and PFR were obtained from 142 men and 88 women, all of whom were healthy Nigerians. The mean values of PFR were 482·1 1/min (±83·3) for males (average age 34·9 years) and 385·6 1/min (±65·7) for females (average age 29·4 years), both means being significantly lower than corresponding means of predicted values calculated from formulae based on previously reported studies of Caucasians. PFR was correlated with age, various physical measurements, and lung volumes. The combination of age and height gave the regression equation for predicting PFR with the lowest standard error of estimates; and virtually all lung volumes measured correlated significantly with PFR. In 16 adult Nigerian asthmatics, PFR correlated significantly with vital capacity, forced expiratory volume (1 second), and expiratory reserve volume; it was highest in those who had no symptomatic or spirometric signs of any ventilatory defect, and lowest in those who had signs of both obstructive and restrictive defects.