Title: Thoracic and Cardiovascular Surgeon

Title: Thorax

ISO Abbreviated Title: Thorax

JCR Abbreviated Title: Thorax

ISSN: 0040-6376

Issues/Year: 12

Journal Country/Territory: England

Language: English

Publisher: British Med Journal Publ Group

Publisher Address: British Med Assoc House, Tavistock Square, London WC1H 9JR, England

Subject Categories:

Respiratory System: Impact Factor

? Devereux, G., Ayatollahi, T., Ward, R., Bromly, C., Bourke, S.J., Stenton, S.C. and Hendrick, D.J. (1996), Asthma, airways responsiveness and air pollution in 2 contrasting districts of Northern England. Thorax, 51, 169-174.

Full Text: Thorax51, 169.pdf

Abstract: BACKGROUND-To assess the possible magnitude of differences between normal populations an epidemiological investigation of asthma was conducted in two strongly contrasting districts of northern England-rural West Cumbria on the west coast and urban Newcastle upon Tyne on the east coast.

METHODS-A cross sectional survey of randomly identified men aged 20-44 years was conducted in two phases: phase 1, a postal survey of respiratory symptoms and asthma medication in 3000 men from each district; and phase 2, a clinical assessment of 300 men from each district comprising investigator administered questionnaires, skin prick tests, spirometry and methacholine challenge tests.

RESULTS-The phase 1 (but not phase 2) study showed a small excess of ‘ever wheezed’) in Newcastle (44% versus 40%), but neither phase showed differences between the two districts for recent wheeze or for other symptoms characteristic of asthma. There were also no differences with regard to diagnosed asthma, current asthma medication, spirometric parameters, or airways responsiveness. The prevalence of quantifiable airways responsiveness (PD20 less than or equal to 6400 µg) was 27.7% in West Cumbria and 28.2% in Newcastle. Regression analyses showed that PD20 was negatively associated with atopy and positively with forced expiratory volume in one second (FEV (1)); that an association between PD20 and current smoking could be explained by diminished FEV (1); and that PD20 was not related to geographical site of residence.

CONCLUSIONS Neither airways responsiveness nor the other parameters of diagnostic relevance to asthma varied much between the two study populations, despite the apparent environmental differences. The most obvious of these were the levels of outdoor air pollution attributable to vehicle exhaust emissions, the ambient levels of which were 2-10 fold greater in Newcastle. Our findings consequently shed some doubt over the role of such pollution in perceived recent increases in asthma prevalence. It is possible, however, that an air pollution effect in Newcastle has been balanced by asthmagenic effects of other agents in West Cumbria.

? Scarlett, J.F., Abbott, K.J., Peacock, J.L., Strachan, D.P. and Anderson, H.R. (1996), Acute effects of summer air pollution on respiratory function in primary school children in southern England. Thorax, 51, 1109-1114.

Abstract: BACKGROUND-There is growing concern about health effects of air pollution in the UK. Studies in the USA have reported adverse effects on lung function among children but no comparable studies have been published in the UK. This study investigates the relationship between daily changes in ambient air pollution and short term variations in lung function in a panel of school children.

METHODS-One hundred and fifty four children aged 7-11 attending a primary school adjacent to a major motorway in Surrey, south-east England, were studied. fellows spirometry was performed daily on 31 schooldays between 6 June and 21 July 1994. Levels of ozone, nitrogen dioxide and particulates of less than 10 µm in diameter (PM (10)) were measured continuously at the school and the pollen count was measured six miles away. Relationships between daily changes in forced expiratory volume in 0.75 seconds (FEV (0.75)), forced vital capacity (FVC), the FEV (0.75)/FVC ratio and pollutants were analysed using separate autoregressive models for each child. A weighted average of the resulting slopes was then calculated.

RESULTS-There was a significant inverse relationship between daily mean PM (10) levels lagged one day and FVC, with a reduction in lung function of 1% (95% CI 0.3% to 2%) across the whole range of PM (10) levels (20-150 µg/m³). The effect on FEV (0.75) was similar (-0.5%) but was not significant when weighted by 1/SE (2) (95% CI-1.2% to 0.2%). There was no effect of PM (10) levels on the FEV (0.75)/FVC ratio. No significant association was seen between FEV (0.75), FVC, or the FEV (0.75)/FVC ratio and either ozone or nitrogen dioxide levels. There was no evidence that wheezy children were more affected than healthy children. Pollen levels on the previous day had no effect on lung function and did not change the air pollution results.

CONCLUSIONS-There is a very small, but statistically significant, adverse effect of airborne respirable particulate matter, measured as PM (10), on lung function in this study group. There is no evidence for an inverse association of lung function with levels of ozone or NO₂ measured on the previous day.

? Partridge, M.R., Rippon, I. and Lewison, G. (2003), WHO funds UK respiratory research? Thorax, 58, 22.

Full Text: Thorax58, 22.pdf