The Effects of Short-Term and Very Short-Term Particulate Matter Exposure on Asthma-Related Hospital Visits: National Health Insurance Data

Digital Healthcare for Airway Diseases from Personal Environmental Exposure

Digital technologies have emerged in various dimensions of human life, ranging from education to professional services to well-being. In particular, health products and services have expanded by the use and development of artificial intelligence, mobile health applications, and wearable electronic devices. Such advancements have enabled accurate and updated tracking and modeling of health conditions. For instance, digital health technologies are capable of measuring environmental pollution and predicting its adverse health effects. Several health conditions, including chronic airway diseases such as asthma and chronic obstructive pulmonary disease, can be exacerbated by pollution. These diseases impose substantial health burdens with high morbidity and mortality. Recently, efforts have been made to develop digital technologies to alleviate such conditions. Moreover, the COVID-19 pandemic has facilitated the application of telemedicine and telemonitoring for patients with chronic airway diseases. This article reviews current trends and studies in digital technology utilization for investigating and managing environmental exposure and chronic airway diseases. First, we discussed the recent progression of digital technologies in general environmental healthcare. Then, we summarized the capacity of digital technologies in predicting exacerbation and self-management of airway diseases. Concluding these reviews, we provided suggestions to improve digital health technologies' abilities to reduce the adverse effects of environmental exposure in chronic airway diseases, based on personal exposure-response modeling.

The Impact of an Urban Scrapyard Fire on Respiratory-Related Pediatric Emergency Department Visits

OBJECTIVE

In Philadelphia, a scrapyard fire generated PM2.5 concentrations >1000 μg/m. We assessed whether this was associated with pediatric emergency department visits for respiratory diagnoses.

DESIGN/METHODS

Retrospective observational study using electronic health record data from a local, academic pediatric hospital.

RESULTS

Compared to the two-week period before the fire, patients living directly north of the fire (downwind) had a significant difference in all asthma diagnoses (OR = 3.02, P = 0.03); asthma and upper respiratory infection (OR = 17.3, P = 0.01); overall admissions (OR = 3.04, P = 01); asthma admissions (OR = 4.45, P = .01); and asthma and upper respiratory infection admissions (OR = 15.0, P = 0.01). We did not observe any significant differences among visits or admissions from patients residing in other adjacent zip codes.

CONCLUSION

A localized, transient increase in PM2.5 was associated with increased pediatric emergency department visits for asthma among patients living downwind of the fire.

The influence of chlorine in indoor swimming pools on the composition of breathing phase of professional swimmers

OBJECTIVES

Swimming is one of the most popular forms of physical activity. Pool water is cleaned with chlorine, which - in combination with compounds contained in water - could form chloramines and trichloromethane in the swimmer's lungs. The aim of the present study was to examine the effect of swimming training in an indoor pool on the composition of swimmers' respiratory phase metabolomics, and develop a system to provide basic information about its impact on the swimmer's airway mucosa metabolism, which could help to assess the risk of secondary respiratory tract diseases i.e. sport results, condition, and health including lung acute and chronic diseases).

DESIGN

A group of competitive swimmers participated in the study and samples of their respiratory phase before training, immediately after training, and 2 h after training were assessed.

METHODS

Sixteen male national and international-level competitive swimmers participated in this study. Respiratory phase analysis of the indoor swimming pool swimmers was performed. Gas chromatography combined with mass spectrometry (GCMS) was used in the measurements. All collected data were transferred to numerical analysis for trends of tracking and mapping. The breathing phase was collected on special porous material and analyzed using GCMS headspace.

RESULTS

The obtained samples of exhaled air were composed of significantly different metabolomics when compared before, during and after exercise training. This suggests that exposition to indoor chlorine causes changes in the airway mucosa.

CONCLUSION

This phenomenon may be explained by occurrence of a chlorine-initiated bio-reaction in the swimmers' lungs. The obtained results indicate that chromatographic exhaled gas analysis is a sensitive method of pulmonary metabolomic changes assessment. Presented analysis of swimmers exhaled air indicates, that indoor swimming may be responsible for airway irritation caused by volatile chlorine compounds and their influence on lung metabolism.

Effects of Indoor Air Purifiers on Children with Asthma

PURPOSE

To evaluate the effects of air purifiers on the concentrations of indoor air pollutants and on asthma control in children.

MATERIALS AND METHODS

In this randomized crossover trial, daily use of an air purifier filter was compared with a matched placebo with the filter off. Thirty elementary school students who had asthma were enrolled and randomly allocated to one of two groups. The primary endpoints were changes in indoor air quality, asthma severity, lung function, airway inflammatory, urine microbiome, and phthalate after the installation of air purifiers. PM_2.5 and CO₂ were measured as indoor air pollutants. Asthma severity was assessed in terms of both symptom and medication scores acquired using a daily questionnaire. The higher the score, the better the symptom or the less frequent the use of medication. Peak expiratory flow rate and fractional exhaled nitric oxide were also measured.

RESULTS

The mean age of the enrolled patients was 9.2±1.98 years. The mean concentration of PM_2.5 was 17.0 μg/m³ in the filter-off condition, but significantly lower at 9.26 μg/m³ in the filter-on condition. Medication scores were 6.9 for the filter-off and 7.12 for the filter-on conditions, reflecting a statistically significant decrease in the frequency of medications used during air purifier operation. Bacterial richness, as determined using the Chao 1 index, was markedly lower in the filter-on than the filter-off condition.

CONCLUSION

This study suggests that air purifiers benefit medication burden in children with asthma by reducing PM_2.5 levels.