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Hou XF, Hou CG. Association between acute tobacco exposure and fractional exhaled nitric oxide in patients with chronic obstructive pulmonary disease: National health and Nutrition Examination Survey (NHANES) 2007-2012. Respir Med 2024; 234:107831. [PMID: 39419295 DOI: 10.1016/j.rmed.2024.107831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Revised: 09/29/2024] [Accepted: 10/06/2024] [Indexed: 10/19/2024]
Abstract
BACKGROUND Fractional exhaled nitric oxide (FeNO) is a marker of type 2 airway inflammation. Tobacco exposure can lower FeNO levels. However, the effect of acute tobacco exposure on FeNO in patients with chronic obstructive pulmonary disease (COPD) is unclear. This study aimed to investigate the relationship of acute tobacco exposure with FeNO and eosinophils in COPD patients. METHODS This retrospective cohort study included 445 patients with COPD based on the 2007-2012 National Health and Nutrition Examination Survey. Serum cotinine levels were examined to assess environmental tobacco smoke exposure. The patients were divided into five groups based on cotinine levels: Q1 (first quintile), Q2 (second quintile), Q3 (third quintile), Q4 (fourth quintile) and Q5 (fifth quintile). Logistic regression models and linear logistic regression models were used to evaluate the relationship between serum cotinine and FeNO and EOS levels. RESULTS Approximately 16.5 % (75/445) of the participants had elevated FeNO (>25 bbp). In the unadjusted model, COPD patients with the lowest quintile of serum cotinine levels (0.011-0.0185 ng/mL) had higher FeNO levels compared to those with the highest quintile (≥309 ng/mL) (odds ratios (OR), 5.86 [2.11-16.20]). These findings remained consistent even after adjusting for covariates of demographics, lifestyle, diabetes, coronary heart disease, tumours, hypertension, using oral or inhaled steroids within 2 days, asthma and respiratory symptoms within 7 days. Furthermore, a standard deviation increase of ln-transformed cotinine levels was associated with decreased FeNO levels (OR, 0.45 [0.33, 0.60]). No significant correlation was observed betweenserum cotinine and blood eosinophils. After high extents of tobacco exposure, no correlation was found between FeNO and eosinophils. Our findings indicate that high cotinine levels are associated with decreased FeNO in COPD patients but not with blood eosinophils. This reveals that smoking may affect FeNO levels in patients with COPD, whereas it does not appear to influence blood eosinophil levels.
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Affiliation(s)
- Xing Fang Hou
- Department of Respiratory and Critical Care Medicine, The First Hospital of Changsha, Changsha, 410000, China.
| | - Cheng Gou Hou
- Medical Imaging Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, China.
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Blanco-Aparicio M, González-Barcala FJ, Padilla Galo A. Dispositivos de medición de FENO. OPEN RESPIRATORY ARCHIVES 2022. [PMID: 37496969 PMCID: PMC10369607 DOI: 10.1016/j.opresp.2022.100207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The use of devices for measuring the exhaled fraction of nitric oxide has proven to be very useful, especially in the diagnosis of asthma, prediction of response to corticosteroids, risk of exacerbations or compliance with treatment, among others, and their use is recommended by important clinical practice guidelines. In recent years we have witnessed a proliferation of options on the market with different characteristics. To help in choosing a device that suits the needs of the professionals involved in the management of asthma, this review presents some of the important characteristics of the most common devices. In addition, the existing comparative and pharmacoeconomic studies are analyzed so that professionals can make the choice of device guided by the most current evidence.
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Evolution of Airway Inflammation in Preschoolers with Asthma-Results of a Two-Year Longitudinal Study. J Clin Med 2020; 9:jcm9010187. [PMID: 31936693 PMCID: PMC7020050 DOI: 10.3390/jcm9010187] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/04/2020] [Accepted: 01/06/2020] [Indexed: 12/12/2022] Open
Abstract
Fractional exhaled nitric oxide (FeNO) is a non-invasive marker for eosinophilic airway inflammation and has been used for monitoring asthma. Here, we assess the characteristics of FeNO from preschool to school age, in parallel with asthma activity. A total of 167 asthmatic children and 66 healthy, age-matched controls were included in the 2-year prospective PreDicta study evaluating wheeze/asthma persistence in preschool-aged children. Information on asthma/rhinitis activity, infections and atopy was recorded at baseline. Follow-up visits were performed at 6-month intervals, as well as upon exacerbation/cold and 4–6 weeks later in the asthmatic group. We obtained 539 FeNO measurements from asthmatics and 42 from controls. At baseline, FeNO values did not differ between the two groups (median: 3.0 ppb vs. 2.0 ppb, respectively). FeNO values at 6, 12, 18 and 24 months (4.0, CI: 0.0–8.6; 6.0, CI: 2.8–12.0; 8.0, CI: 4.0–14.0; 8.5, CI: 4.4–14.5 ppb, respectively) increased with age (correlation p ≤ 0.001) and atopy (p = 0.03). FeNO was non-significantly increased from baseline to the symptomatic visit, while it decreased after convalescence (p = 0.007). Markers of disease activity, such as wheezing episodes and days with asthma were associated with increased FeNO values during the study (p < 0.05 for all). Age, atopy and disease activity were found to be important FeNO determinants in preschool children. Longitudinal and individualized FeNO assessment may be valuable in monitoring asthmatic children with recurrent wheezing or mild asthma.
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Silkoff PE, Awabdy B, Sarno M, Ssenyange S, Balsubramanyam V, Leard R. Clinical precision, accuracy, number and durations of exhalations for a novel electrochemical monitor for exhaled nitric oxide. J Breath Res 2019; 14:016011. [PMID: 31891568 DOI: 10.1088/1752-7163/ab5422] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Exhaled nitric oxide (FeNO) is a validated marker of eosinophilic inflammation. Fenom ProTM is a novel FDA-cleared monitor for FeNO. The American Thoracic Guidelines from 2005 recommend at least 6 s exhalation for adults and in some cases up to 10 s, and 4 s for children, and that the average of the first two valid exhalations is taken as the FeNO value. METHODS Clinical precision, 6 versus 10 s exhalations, the first versus the average of the first two valid exhalation methods comparison were evaluated for Fenom ProTM, as well as a methods comparison to the NIOX VERO® monitor. RESULTS The intent-to-treat population (n = 126) consisted of 83 adults, and 43 pediatric subjects with 16 subjects under 12 years of age. Clinical precision for 10 s exhalations on Fenom ProTM was excellent with a within-subject standard deviation (SD) range of 0.57-3.73 ppb and mean coefficient of variation (CV) range of 4.21% to 9.65%. The clinical precision for the separate adult and pediatric groups as well as for the 6 s exhalations were similar. The 10 and 6 s exhalation comparisons and one versus the average of two valid exhalations showed a high level of agreement. The Fenom ProTM and the NIOX VERO® monitors also demonstrated a high level of agreement with the values from the latter slightly lower (mean bias of -3.2 ppb). CONCLUSION Fenom ProTM demonstrated eminently acceptable performance supporting its clinical utility. The data suggests that 6 s exhalations can be used in adults and children, and that one exhalation is adequate rather than obtaining the average of two exhalations on Fenom ProTM.
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Affiliation(s)
- Philip E Silkoff
- 827 N 21st Street, Philadelphia, PA, 19130, United States of America
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Liu J, Xu R, Zhan C, Luo W, Lai K, Zhong N, Chen W, Chen R. Clinical utility of ultrahigh fractional exhaled nitric oxide in predicting bronchial hyperresponsiveness in patients with suspected asthma. Postgrad Med J 2019; 95:541-546. [PMID: 31296792 DOI: 10.1136/postgradmedj-2018-136333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 05/18/2019] [Accepted: 06/23/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Fractional exhaled nitric oxide (FeNO) is a non-invasive biomarker for airway eosinophilic inflammation. However, the clinical value of ultrahigh FeNO (≥100 parts per billion (ppb)) in predicting asthma is never explored. We aimed to investigate the value of ultrahigh FeNO as a predictor of bronchial hyperresponsiveness (BHR), an important index for asthma diagnosis. METHODS A retrospective cohort study was conducted on 259 patients with suspected asthma who received the examination of FeNO, spirometry, bronchial provocation test (BPT) and differential cell count of induced sputum. Patients were stratified by FeNO value: ultrahigh (group A:≥100 ppb), high (group B: 50-99 ppb), intermediate (group C: 26-49 ppb) and normal (group D:≤25 ppb). The positive rates of BPT and sputum eosinophils percentage (Eos%) were compared among four cohorts. The correlations between FeNO and sputum Eos% were measured. RESULTS A significant higher positive rate of BPT was observed in group A (90.91%) than all others (B: 51.43%, C: 31.43%, D: 28.13%, all p<0.01). Referring to group D, the ORs of positive BPT in groups A, B and C were 26.84, 2.84 and 1.05. Sputum Eos% in group A (19.75 (7.00, 46.25)) is higher than that in others (B: 3.50 (1.00, 12.75), C: 1.13 (0.06,3.50), D: 0.50 (0.00, 2.13)). FeNO correlates with sputum Eos% in groups A and B, but not group C or D. CONCLUSIONS Ultrahigh FeNO correlates with BHR and could serve as a practical alternative to methacholine challenge to support an asthma diagnosis in patients with suspected asthma in primary care.
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Affiliation(s)
- Jiaxing Liu
- Department of Respirology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Rong Xu
- Department of Respirology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chen Zhan
- Department of Respirology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei Luo
- Department of Respirology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kefang Lai
- Department of Respirology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Nanshan Zhong
- Department of Respirology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei Chen
- Department of Biostatistics, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ruchong Chen
- Department of Respirology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Molino A, Fuschillo S, Mosella M, Accardo M, Guida P, Motta A, Maniscalco M. Comparison of three different exhaled nitric oxide analyzers in chronic respiratory disorders. J Breath Res 2019; 13:021002. [PMID: 30673653 DOI: 10.1088/1752-7163/ab0167] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Fractional exhaled nitric oxide (FeNO) measurement is a simple and non-invasive method for monitoring eosinophilic airway inflammation. New portable analyzers for FeNO measurements are constantly being developed. The aim of our study was to evaluate the agreement of FeNO values measured by new portable analyzers. MATERIALS AND METHODS FeNO was measured in 20 healthy subjects, 20 asthmatic and 20 chronic obstructive pulmonary disease patients using the analyzers Niox-VERO, Vivatmo-PRO and HypAir-FeNO. A linear relationship was estimated with Pearson's coefficient (r), and absolute agreement by the intraclass correlation coefficient (ICC) and bias with the limits of agreement (95% of paired differences) were assessed according to the Bland-Altman method. RESULTS In the study population (58 ± 14 years, 20 females), mean values of FeNO with their 95% confidence interval were 24.0 (18.6-29.4) with the Niox-VERO, 19.6 (13.6-25.7) with the Vivatmo-PRO and 20.4 (15.7-25.1) with the HypAir-FeNO. FeNO measured with the Niox-VERO was higher than the Vivatmo-PRO (mean difference of paired values +4.3; limits -16.0 to 25.7 ppb) and the HypAir-FeNO (+3.6; -12.2 to 19.4 ppb); the Vivatmo-PRO and HypAir-FeNO showed large variability of paired differences (-0.7; -16.5 to 15.0 ppb). Measurements linearly correlated with an imperfect absolute agreement: Niox-VERO versus Vivatmo-PRO r = 0.90 and ICC = 0.87; Niox-VERO versus HypAir-FeNO r = 0.93 and ICC = 0.90, Vivatmo-PRO versus HypAir-FeNO r = 0.96 and ICC = 0.93. Most of the disagreement was greater in some asthmatic patients at high values of FeNO. CONCLUSIONS The present study indicates that absolute exhaled NO measurements may differ to a clinically relevant extent using the Niox-VERO, Vivatmo-PRO and HypAir-FeNO analyzers. The devices cannot be used interchangeably.
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Affiliation(s)
- Antonio Molino
- Department of Respiratory Medicine, University Federico II 80131 (Naples) Italy
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Kim MH, Kim SH, Park SY, Ban GY, Kim JH, Jung JW, Moon JY, Song WJ, Kwon HS, Kwon JW, Lee JH, Kang HR, Park JS, Kim TB, Park HW, Yoo KH, Oh YM, Koh YI, Jang AS, Lee BJ, Cho YJ, Cho SH, Park HS, Park CS, Yoon HJ, Cho YS. Characteristics of Adult Severe Refractory Asthma in Korea Analyzed From the Severe Asthma Registry. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2019; 11:43-54. [PMID: 30479076 PMCID: PMC6267188 DOI: 10.4168/aair.2019.11.1.43] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 08/24/2018] [Accepted: 08/28/2018] [Indexed: 12/18/2022]
Abstract
Purpose Although mild to moderate asthma is much more common, the morbidity and mortality of severe asthma are much higher. This study was performed to identify and analyze the clinical characteristics of severe asthma in Korea. Methods We registered patients with severe refractory asthma into the Severe Asthma Registry supported by the Severe Asthma Work Group of the Korean Academy of Asthma, Allergy and Clinical Immunology. Patients were enrolled since 2010 from the 15 university hospitals nationwide in Korea. Severe asthma was defined according to modified European Respiratory Society/American Thoracic Society criteria. Information on demographics, medical history, pulmonary function tests and skin prick tests was collected; the clinical characteristics of severe asthmatics were analyzed from the collected data. Results A total of 489 patients were enrolled with a mean age of 62.3; 45% are male. Sixty percent of patients received Global Initiative for Asthma step 4 treatment, and 30% received step 5 treatment. The most common comorbidities were allergic rhinitis (58.7%). Aspirin hypersensitivity was observed in 14.0%. Approximately half (53.9%) are non-smokers. Atopy was proven in 38.5% of the patients. Regarding asthma medications, inhaled corticosteroids and long-acting β-agonist combination inhalers were most commonly prescribed (96.5%), followed by leukotriene antagonists (71.0%). A recombinant anti-immunoglobulin E monoclonal antibody (omalizumab) has been used in 1.8% of the patients. The mean forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and FEV1/FVC were 78.7%, 67.5% and 67.9% of predicted values, respectively. The mean Asthma Control Test and quality of life questionnaire scores were 16.5 out of 25 and 59.5 out of 85, respectively. Conclusions The baseline characteristics of severe asthma patients in the Korea Severe Asthma Registry were analyzed and reported for the first time. With this cohort, further prospective studies should be performed to search for ways to improve management of severe refractory asthma.
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Affiliation(s)
- Min Hye Kim
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Sang Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - So Young Park
- Department of Allergy and Respiratory Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Ga Young Ban
- Department of Pulmonary, Allergy and Critical Care Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Joo Hee Kim
- Department of Internal Medicine, Hallym University College of Medicine, Anyang, Korea
| | - Jae Woo Jung
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ji Yong Moon
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Woo Jung Song
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyouk Soo Kwon
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Woo Kwon
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jae Hyun Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Ryun Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jong Sook Park
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Tae Bum Kim
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Heung Woo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang Ha Yoo
- Department of Allergy and Respiratory Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Yeon Mok Oh
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Il Koh
- Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - An Soo Jang
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Byung Jae Lee
- Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Joo Cho
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Sang Heon Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hae Sim Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Choon Sik Park
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Ho Joo Yoon
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
| | - You Sook Cho
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Maniscalco M, Fuschillo S, Gaudiosi C, De Felice A, Martucci M, Motta A. Exhaled and nasal nitric oxide measurement in the evaluation of chronic cough. Nitric Oxide 2018; 83:19-23. [PMID: 30557619 DOI: 10.1016/j.niox.2018.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/22/2018] [Accepted: 12/13/2018] [Indexed: 12/12/2022]
Abstract
Chronic cough is one of the most common and troublesome nonspecific respiratory symptom for which patients seek a general practitioner and specialist advice. It is conventionally defined as a cough lasting for more than 8 weeks. Exhaled nitric oxide has proven to be a specific biomarker capable to discriminate between differential diagnoses of chronic cough and simultaneously provide information about the response to specific treatment. In this review, we will discuss the potential use of exhaled and nasal nitric oxide in the diagnosis of chronic chough.
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Affiliation(s)
- Mauro Maniscalco
- Pulmonary Rehabilitation Unit, ICS Maugeri SpA SB, Institute of Telese Terme, Benevento, Italy.
| | - Salvatore Fuschillo
- Pulmonary Rehabilitation Unit, ICS Maugeri SpA SB, Institute of Telese Terme, Benevento, Italy
| | - Carlo Gaudiosi
- Pulmonary Rehabilitation Unit, ICS Maugeri SpA SB, Institute of Telese Terme, Benevento, Italy
| | - Alberto De Felice
- Pulmonary Rehabilitation Unit, ICS Maugeri SpA SB, Institute of Telese Terme, Benevento, Italy
| | - Michele Martucci
- Pulmonary Rehabilitation Unit, ICS Maugeri SpA SB, Institute of Telese Terme, Benevento, Italy
| | - Andrea Motta
- Institute of Biomolecular Chemistry, National Research Council, 80078, Pozzuoli, Naples, Italy
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Gomà A, de Lluis R, Roca-Ferrer J, Lafuente J, Picado C. Respiratory, ocular and skin health in recreational and competitive swimmers: Beneficial effect of a new method to reduce chlorine oxidant derivatives. ENVIRONMENTAL RESEARCH 2017; 152:315-321. [PMID: 27835856 DOI: 10.1016/j.envres.2016.10.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 10/27/2016] [Accepted: 10/27/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Chlorine by-products may irritate the eyes, nose, skin and airways of swimmers and may cause chronic airway inflammation. OBJECTIVE To assess the salutary effects on swimmers health of a new method of water disinfection. METHODS Recreational (n=320) and competitive swimmers (n=53) participated in the study. The first part of the study (Phase A) was carried out while using the current standard method. The second part (Phase B) began 8 weeks after the new method had been introduced. Total oxidants in air and chlorine species in water were assessed by standard methods. All swimmers completed a questionnaire on health complaints. Exhaled breath condensate (EBC) was used to monitor the levels of leukotriene B4 (LTB4) and cysteinyl leukotrienes (CysLTs) in airway from competitive swimmers. RESULTS The new system resulted in a 75% and 39% reduction in the concentration of total oxidants and of nitrogen trichloride respectively in the air of the swimming pool. With the new system recreational swimmers experienced fewer symptoms of cough and irritation of the eyes, nose and skin. A decrease in eye irritation symptoms was also noted by competitive swimmers. The baseline concentration of CysLTs in EBC decreased significantly in Phase B with respect to Phase A. CONCLUSIONS The new method markedly reduced the levels of irritant oxidant substances in the pool atmosphere that resulted in a reduction of eye, nose, skin and cough complaints in recreational swimmers, and eye irritation in competitive swimmers. It was also associated with reduced CysLT levels in the airways of competitive swimmers.
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Affiliation(s)
- Anton Gomà
- Grup GENOCOV, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Rosó de Lluis
- Servei de Pneumologia i Al·lèrgia Respiratoria, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigaciones en Red de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Jordi Roca-Ferrer
- Servei de Pneumologia i Al·lèrgia Respiratoria, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigaciones en Red de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Javier Lafuente
- Grup GENOCOV, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - César Picado
- Servei de Pneumologia i Al·lèrgia Respiratoria, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigaciones en Red de Enfermedades Respiratorias (CIBERES), Barcelona, Spain.
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Kwon JW, Song WJ, Kim MH, Lim KH, Yang MS, Jung JW, Lee J, Suh DI, Shin YS, Kim SH, Kim SH, Lee BJ, Cho SH. The KAAACI Standardization Committee Report on the procedure and application of fractional exhaled nitric oxide measurement. ALLERGY ASTHMA & RESPIRATORY DISEASE 2017. [DOI: 10.4168/aard.2017.5.4.185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Jae-Woo Kwon
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Woo-Jung Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Min-Hye Kim
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kyung-Hwan Lim
- Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Min-Suk Yang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jae-Woo Jung
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jeongmin Lee
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo Seob Shin
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Sae-Hoon Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Byung-Jae Lee
- Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang-Heon Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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