Indoor pollutant exposure is associated with heightened respiratory symptoms in atopic compared to non-atopic individuals with COPD

BMC Pulmonary Medicine

Nadia N Hansel⁴  Patrick N Breysse⁴  Gregory B Diette⁴  Roger D Peng¹  Nirupama Putcha²  Laura Paulin²  D’Ann L Williams⁴  Elizabeth C Matsui³  Meredith C McCormack⁴  Andrew J Belli²  Deepak A Kaji² 

[1] Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA;Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA;Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA

关键词: Susceptibility;    Indoor air;    PM;    Particulate matter;    Pollutants;    Allergic sensitization;    Atopy;    COPD;   

Others  :  1109528
DOI  :  10.1186/1471-2466-14-147

 received in 2014-04-22, accepted in 2014-08-26,  发布年份 2014

【 摘 要 】

Background

Indoor particulate matter (PM) has been linked to respiratory symptoms in former smokers with COPD. While subjects with COPD and atopy have also been shown to have more frequent respiratory symptoms, whether they exhibit increased susceptibility to PM as compared to their non-atopic counterparts remains unclear. The aim of this study was to determine whether atopic individuals with COPD have greater susceptibility to PM compared to non-atopic individuals with COPD.

Methods

Former smokers with moderate to severe COPD were enrolled (n = 77). PM_2.5, PM with diameter <2.5 micrometers, was measured in the main living area over three one-week monitoring periods at baseline, 3, and 6 months. Quality of life, respiratory symptoms and medication use were assessed by questionnaires. Serum was analyzed for specific IgE for mouse, cockroach, cat, dog and dust mite allergens. Atopy was established if at least one test was positive. Interaction terms between PM and atopy were tested and generalized estimating equation analysis determined the effect of PM concentrations on health outcomes. Multivariate models were adjusted for age, sex, education, race, season, and baseline lung function and stratified by atopic status.

Results

Among atopic individuals, each 10 μg/m³ increase in PM was associated with higher risk of nocturnal symptoms (OR, 1.95; P = 0.02), frequent wheezing (OR, 2.49; P = 0.02), increased rescue medication use (β = 0.14; P = 0.02), dyspnea (β = 0.23; P < 0.001), higher St. George’s Respiratory Quality of Life score (β = 2.55; P = 0.01), and higher breathlessness, cough, and sputum score (BCSS) (β = 0.44; P = 0.01). There was no association between PM and health outcomes among the non-atopic individuals. Interaction terms between PM_2.5 and atopy were statistically significant for nocturnal symptoms, frequency of rescue medication use, and BCSS (all P < 0.1).

Conclusions

Individuals with COPD and atopy appear to be at higher risk of adverse respiratory health effects of PM exposure compared to non-atopic individuals with COPD.

【 授权许可】

   
2014 Kaji et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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