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Personal exposure to nitrogen dioxide (NO2) and the severity of virus-induced asthma in children

Personal exposure to nitrogen dioxide (NO2) and the severity of virus-induced asthma in children
Personal exposure to nitrogen dioxide (NO2) and the severity of virus-induced asthma in children
Background: A link between exposure to the air pollutant nitrogen dioxide (NO2) and respiratory disease has been suggested. Viral infections are the major cause of asthma exacerbations. We aimed to assess whether there is a relation between NO2 exposure and the severity of asthma exacerbations caused by proven respiratory viral infections in children.
Methods: A cohort of 114 asthmatic children aged between 8 and 11 years recorded daily upper and lower respiratory-tract symptoms, peak expiratory flow (PEF), and measured personal NO2 exposures every week for up to 13 months. We took nasal aspirates during reported episodes of upper respiratory-tract illness and tested for infection by common respiratory viruses and atypical bacteria with RT-PCR assays. We used generalised estimating equations to assess the relation between low (<7·5 ?g/m3), medium (7·5–14 ?g/m3), and high (>14 ?g/m3) tertiles of NO2 exposure in the week before or after upper respiratory-tract infection and the severity of asthma exacerbation in the week after the start of an infection.
Findings: One or more viruses were detected in 78% of reported infection episodes, and the medians of NO2 exposure were 5 (IQR 3·6–6·3), 10 (8·7–12·0), and 21 ?g/m3 (16·8–42·9) for low, medium, and high tertiles, respectively. There were significant increases in the severity of lower respiratory-tract symptom scores across the three tertiles (0·6 for all viruses [p=0·05] and >2 for respiratory syncytial virus [p=0·01]) and a reduction in PEF of more than 12 L/min for picornavirus (p=0·04) for high compared with low NO2 exposure before the start of the virus-induced exacerbation.
Interpretation: High exposure to NO2 in the week before the start of a respiratory viral infection, and at levels within current air quality standards, is associated with an increase in the severity of a resulting asthma exacerbation.
0140-6736
1939-1944
Chauhan, A.J.
80ced09a-aebc-4540-82f1-eef6cb8e7f2d
Inskip, Hazel M.
5fb4470a-9379-49b2-a533-9da8e61058b7
Linaker, Catherine H.
6c6d1b90-ee40-4c96-8b2e-b06efbe030ae
Smith, Sandra
4cb052d0-306e-42be-8e60-86cda691e1bb
Schreiber, Jacqueline
cb469893-96ac-4be6-af54-e6ba1a98fc65
Johnston, Sebastian L.
90e0ef79-cfde-40e0-b301-90d3063ee036
Holgate, Stephen T.
2e7c17a9-6796-436e-8772-1fe6d2ac5edc
Chauhan, A.J.
80ced09a-aebc-4540-82f1-eef6cb8e7f2d
Inskip, Hazel M.
5fb4470a-9379-49b2-a533-9da8e61058b7
Linaker, Catherine H.
6c6d1b90-ee40-4c96-8b2e-b06efbe030ae
Smith, Sandra
4cb052d0-306e-42be-8e60-86cda691e1bb
Schreiber, Jacqueline
cb469893-96ac-4be6-af54-e6ba1a98fc65
Johnston, Sebastian L.
90e0ef79-cfde-40e0-b301-90d3063ee036
Holgate, Stephen T.
2e7c17a9-6796-436e-8772-1fe6d2ac5edc

Chauhan, A.J., Inskip, Hazel M., Linaker, Catherine H., Smith, Sandra, Schreiber, Jacqueline, Johnston, Sebastian L. and Holgate, Stephen T. (2003) Personal exposure to nitrogen dioxide (NO2) and the severity of virus-induced asthma in children. Lancet, 361 (9373), 1939-1944. (doi:10.1016/S0140-6736(03)13582-9).

Record type: Article

Abstract

Background: A link between exposure to the air pollutant nitrogen dioxide (NO2) and respiratory disease has been suggested. Viral infections are the major cause of asthma exacerbations. We aimed to assess whether there is a relation between NO2 exposure and the severity of asthma exacerbations caused by proven respiratory viral infections in children.
Methods: A cohort of 114 asthmatic children aged between 8 and 11 years recorded daily upper and lower respiratory-tract symptoms, peak expiratory flow (PEF), and measured personal NO2 exposures every week for up to 13 months. We took nasal aspirates during reported episodes of upper respiratory-tract illness and tested for infection by common respiratory viruses and atypical bacteria with RT-PCR assays. We used generalised estimating equations to assess the relation between low (<7·5 ?g/m3), medium (7·5–14 ?g/m3), and high (>14 ?g/m3) tertiles of NO2 exposure in the week before or after upper respiratory-tract infection and the severity of asthma exacerbation in the week after the start of an infection.
Findings: One or more viruses were detected in 78% of reported infection episodes, and the medians of NO2 exposure were 5 (IQR 3·6–6·3), 10 (8·7–12·0), and 21 ?g/m3 (16·8–42·9) for low, medium, and high tertiles, respectively. There were significant increases in the severity of lower respiratory-tract symptom scores across the three tertiles (0·6 for all viruses [p=0·05] and >2 for respiratory syncytial virus [p=0·01]) and a reduction in PEF of more than 12 L/min for picornavirus (p=0·04) for high compared with low NO2 exposure before the start of the virus-induced exacerbation.
Interpretation: High exposure to NO2 in the week before the start of a respiratory viral infection, and at levels within current air quality standards, is associated with an increase in the severity of a resulting asthma exacerbation.

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More information

Published date: 2003
Organisations: Community Clinical Sciences, Infection Inflammation & Immunity, Dev Origins of Health & Disease

Identifiers

Local EPrints ID: 26982
URI: http://eprints.soton.ac.uk/id/eprint/26982
ISSN: 0140-6736
PURE UUID: 29ab17de-ebf1-46c7-a42b-f20a0d34d9b7
ORCID for Hazel M. Inskip: ORCID iD orcid.org/0000-0001-8897-1749
ORCID for Catherine H. Linaker: ORCID iD orcid.org/0000-0003-1091-9283

Catalogue record

Date deposited: 25 Apr 2006
Last modified: 09 Jan 2022 02:52

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Contributors

Author: A.J. Chauhan
Author: Hazel M. Inskip ORCID iD
Author: Sandra Smith
Author: Jacqueline Schreiber
Author: Sebastian L. Johnston

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