Effect of nitrogen dioxide and ozone on the risk of dying in patients with severe asthma

Abstract

Background: A study was performed to assess the acute association between air pollution, pollen and spores, and mortality in a population based cohort of subjects with asthma recruited from emergency room admissions for an asthma exacerbation using a case crossover design. Methods: Patients in Barcelona aged over 14 years who died during the period 1985-95 who had visited the emergency department of one of the four largest hospitals in the city for asthma during 1985-9 were included in the study (a total of 467 men and 611 women). Deaths were identified by record linkage of the cohort individuals with the Catalonia mortality registry. Causes of death were based on the underlying cause on the death certificate. Air pollution, pollen and spore levels were measured at the city monitoring stations which provide an average for the entire city. Results: Nitrogen dioxide was associated with mortality for all causes of death (adjusted odds ratio (OR) for an increase of the interquartile range = 1.50, 95% confidence interval (CI) 1.09 to 2.64) in asthmatic patients with more than one emergency room admission for asthma. The association was particularly strong for respiratory causes (OR 1.63, 95% CI 0.93 to 2.86). Ozone also increased the risk of death in asthmatic patients (OR 1.90, 95% CI 1.09 to 3.30) during spring and summer. The association with particles, pollen, and spores was not significant, and no interactions between air pollutants and pollen and spores were found. Conclusion: Nitrogen dioxide and ozone may exacerbate severe asthma and even cause death among asthmatic subjects.

Effects of air pollution and meteorological parameters on human health in the city of Athens, Greece

“…In our study O 3 results to be irrelevant for circulatory diseases, a conclusion reached also by Anderson et al (1996). The impact of O 3 in respiratory diseases is similar to that obtained by other studies (Brunekreef and Holgate, 2002;Desqueyroux et al, 2002;Sunyer et al, 2002). However, deaths from respiratory diseases attributed to exposure to O 3 are found to be also significant Goldberg et al, 2001;Hong et al, 2002).…”

Interleukin-1 Receptor and Caspase-1 Are Required for the Th17 Response in Nitrogen Dioxide–Promoted Allergic Airway Disease

“…Exposure to NO 2 positively correlates with asthma severity, the risk of hospitalization, disease exacerbation, the risk of death, and the development of asthma in previously healthy children (8)(9)(10). We have reported that NO 2 exposure allergically sensitizes mice to ovalbumin (OVA; we define sensitization as the act or process of inducing an acquired allergy), inducing methacholine airway hyperresponsiveness (AHR), antigen-specific IgG1 and IgE, inflammatory leukocyte recruitment to the airway, and the production of Th2 cytokines and IL-17 during in vitro restimulation of CD4 1 T cells (11,12).…”

Use of Biomass Fuel in Households within Limpopo Province of South Africa and Its Association with Asthma among School Children Aged Thirteen and Fourteen Years of Age

“…It also combines with sulphur dioxide to form inspirable particulate matter (sulphates and nitrates) [26]. Nitrogen dioxide exacerbates asthma and causes death among asthmatics [27]. Sulphur dioxide irritates respiratory tracts and causes airways to close and disrupt lung function [28].…”