☆ 4.4 Article

Poor asthma control and exposure to traffic pollutants and obesity in older adults

ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY (2012)

Journal

ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY

Volume 108, Issue 6, Pages 423-+

Publisher

ELSEVIER SCIENCE INC

DOI: 10.1016/j.anai.2012.04.009

Keywords

Funding

National Institute of Environmental Health Services [P30-ES006096, ES11170]
US Public Health Service [UL1 RR026314]
National Center for Research Resources
National Center for Advancing Translational Sciences, National Institutes of Health [8KL2 TR000078-04]

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Abstract

Background: Environmental and host predictors of asthma control in older asthmatic patients (>65 years old) are poorly understood. Objective: To examine the effects of residential exposure to traffic exhaust and other environmental and host predictors on asthma control in older adults. Methods: One hundred four asthmatic patients 65 years of age or older from allergy and pulmonary clinics in greater Cincinnati, Ohio, completed the validated Asthma Control Questionnaire (ACQ), pulmonary function testing, and skin prick testing to 10 common aeroallergens. Patients had a physician's diagnosis of asthma, had significant reversibility in forced expiratory volume in 1 second or a positive methacholine challenge test result, and did not have chronic obstructive pulmonary disease. The mean daily residential exposure to elemental carbon attributable to traffic (ECAT) was estimated using a land-use regression model. Regression models were used to evaluate associations among independent variables, ACQ scores, and the number of asthma exacerbations, defined as acute worsening of asthma symptoms requiring prednisone use, in the past year. Results: In the adjusted model, mean daily residential exposure to ECAT greater than 0.39 mu g/m(3) was significantly associated with poorer asthma control based on ACQ scores (adjusted beta = 2.85; 95% confidence interval [CI], 0.58-5.12; P = .02). High ECAT levels were also significantly associated with increased risk of asthma exacerbations (adjusted odds ratio, 3.24; 95% CI, 1.01-10.37; P = .05). A significant association was found between higher body mass index and worse ACQ scores (adjusted beta = 1.15; 95% CI, 0.53-1.76; P < .001). Atopic patients (skin prick test positive) had significantly better ACQ scores than nonatopic patients (adjusted beta = -0.39; 95% CI, -0.67 to -0.11; P < .01). Conclusion: Higher mean daily residential exposure to traffic exhaust, obesity, and nonatopic status are associated with poorer asthma control among older asthmatic patients. (C) 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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Long-term exposure to ambient air pollution and road traffic noise and asthma incidence in adults: The Danish Nurse cohort

Shuo Liu, Youn-Hee Lim, Marie Pedersen, Jeanette T. Jorgensen, Heresh Amini, Thomas Cole-Hunter, Amar J. Mehta, Rina So, Laust H. Mortensen, Rudi G. J. Westendorp, Steffen Loft, Elvira Braeuner, Matthias Ketzel, Ole Hertel, Jorgen Brandt, Steen S. Jensen, Jesper H. Christensen, Torben Sigsgaard, Camilla Geels, Lise M. Frohn, Maja Brboric, Jelena Radonic, Maja Turk Sekulic, Klaus Bonnelykke, Claus Backalarz, Mette K. Simonsen, Zorana J. Andersen

Summary: The study found that long-term exposure to air pollution, particularly nitrogen dioxide, is associated with adult asthma incidence. Road traffic noise, on the other hand, is not independently associated with adult asthma incidence.

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