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Controller medications may worsen effects of air pollution on lung function in children with asthma
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Exposure to ozone, carbon monoxide, nitrogen dioxide and sulfur dioxide reduces lung function and airway responsiveness in children with asthma, according to study results.
The researchers also noted that bronchodilator treatment worsens the effects of carbon monoxide on airway responsiveness in children over the short term.
“We found that long-term and even short-term exposure to pollution adversely influenced lung function and triggered airway hyperresponsiveness in children with asthma,” study researcher Diane R. Gold, MD, MPH, an associate physician in the Channing Division of Network Medicine at Brigham and Women’s Hospital in Boston, said in a press release. “The worsening of airway hyperresponsiveness with short-term exposure to carbon monoxide was even stronger for children receiving budesonide and nedocromil compared with placebo, a finding that needs further investigation. This means use of controller medication may not protect asthmatic children from pollutant effects and may actually worsen the negative effects of some pollutants.”
Gold and colleagues reviewed data of 1,003 children aged 5 to 12 years with asthma from the Childhood Asthma Management Program and examined associations of lung function and methacholine responsiveness with ozone, carbon monoxide, nitrogen dioxide and sulfur dioxide concentrations.
The researchers indicated same-day (IQR = –0.33; 95% CI, –0.49 to –0.16) and 1-week average (IQR = –0.41; 95% CI, –0.62 to –0.21) carbon monoxide concentrations negatively correlated with postbronchodilator percent predicted forced expiratory volume in 1 second (FEV1).
The researchers also noted the same results for forced vital capacity (FVC) at same-day (IQR = –0.19; 95% CI, –0.25 to –0.07) and 1-week (IQR = –0.25; 95% CI, –0.43 to –0.07) average,
Longer-term 4-month carbon monoxide averages also had a negative correlation with prebronchodilator percent predicted FEV1 (IQR = –0.36; 95% CI, –0.62 to –0.1) and FVC (–0.21; 95% CI, –0.42 to –0.01).
Study researcher Paul V. Williams, MD, FAAAAI, director of Asthma Inc. Clinical Research Center, stressed in the release the importance of not always using controller medications to treat asthma.
“From a public health standpoint, this means that controller medications should not be assumed to be sufficient as a preventative measure on days with high pollution levels,” he said. Better policy for pollution control is necessary and children who have asthma should continue avoiding outdoor activities on days of high pollution levels.” – by Ryan McDonald
Disclosure: Ierodiakonou reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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