Nasal Peak Inspiratory Flow in Healthy and Obstructed Patients: Systematic Review and <scp>Meta‐Analysis</scp>

Mo, Shirley S.; Gupta, Sai S.; Stroud, Anna; Strazdins, Erika; Hamizan, Aneeza Khairiyah Wan; Rimmer, Janet; Alvarado, Raquel; Kalish, Larry; Harvey, Richard J.

doi:10.1002/lary.28682

Cited by 19 publications

(11 citation statements)

References 40 publications

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“…Three recordings at each time point (Table 6 ) were performed and the highest value was used for analysis [ 80 ]. The PNIF measurements were compared to the baseline value before the exposure on an individual basis, and a decrease in PNIF indicated an increased nasal obstruction [ 81 ].…”

Section: Methodsmentioning

confidence: 99%

Lung function and self-rated symptoms in healthy volunteers after exposure to hydrotreated vegetable oil (HVO) exhaust with and without particles

et al. 2022

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Background Diesel engine exhaust causes adverse health effects. Meanwhile, the impact of renewable diesel exhaust, such as hydrotreated vegetable oil (HVO), on human health is less known. Nineteen healthy volunteers were exposed to HVO exhaust for 3 h in a chamber with a double-blind, randomized setup. Exposure scenarios comprised of HVO exhaust from two modern non-road vehicles with 1) no aftertreatment system (‘HVOPM+NOx’ PM1: 93 µg m−3, EC: 54 µg m−3, NO: 3.4 ppm, NO2: 0.6 ppm), 2) an aftertreatment system containing a diesel oxidation catalyst and a diesel particulate filter (‘HVONOx’ PM1: ~ 1 µg m−3, NO: 2.0 ppm, NO2: 0.7 ppm) and 3) filtered air (FA) as control. The exposure concentrations were in line with current EU occupational exposure limits (OELs) of NO, NO2, formaldehyde, polycyclic aromatic hydrocarbons (PAHs), and the future OEL (2023) of elemental carbon (EC). The effect on nasal patency, pulmonary function, and self-rated symptoms were assessed. Calculated predicted lung deposition of HVO exhaust particles was compared to data from an earlier diesel exhaust study. Results The average total respiratory tract deposition of PM1 during HVOPM+NOx was 27 µg h−1. The estimated deposition fraction of HVO PM1 was 40–50% higher compared to diesel exhaust PM1 from an older vehicle (earlier study), due to smaller particle sizes of the HVOPM+NOx exhaust. Compared to FA, exposure to HVOPM+NOx and HVONOx caused higher incidence of self-reported symptoms (78%, 63%, respectively, vs. 28% for FA, p < 0.03). Especially, exposure to HVOPM+NOx showed 40–50% higher eye and throat irritation symptoms. Compared to FA, a decrement in nasal patency was found for the HVONOx exposures (− 18.1, 95% CI: − 27.3 to − 8.8 L min−1, p < 0.001), and for the HVOPM+NOx (− 7.4 (− 15.6 to 0.8) L min−1, p = 0.08). Overall, no clinically significant change was indicated in the pulmonary function tests (spirometry, peak expiratory flow, forced oscillation technique). Conclusion Short-term exposure to HVO exhaust concentrations corresponding to EU OELs for one workday did not cause adverse pulmonary function changes in healthy subjects. However, an increase in self-rated mild irritation symptoms, and mild decrease in nasal patency after both HVO exposures, may indicate irritative effects from exposure to HVO exhaust from modern non-road vehicles, with and without aftertreatment systems.

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Section: Methodsmentioning

confidence: 99%

Lung function and self-rated symptoms in healthy volunteers after exposure to hydrotreated vegetable oil (HVO) exhaust with and without particles

et al. 2022

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“…A minimally clinically important difference of 20 L/min has been defined and a lack of improvement of 20 L/min or 20% after decongestion may indicate a structural cause of obstruction 1595–1597 . An SRMA reported mean PNIF values in normal adults of 128.4 and 97.5 L/min for obstructed adults 1598 . However, standardized values have yielded inconsistent results due to multiple confounding factors including patient effort, pulmonary status, nasal valve collapse, smoking, height, and recent physical exercise 1599,1600 .…”

Section: Evaluation and Diagnosismentioning

confidence: 99%

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

Wise

Damask

Roland

et al. 2023

Int Forum Allergy Rhinol

151

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Background In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR‐Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR‐Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence‐based findings and recommendation from the full document. Methods ICAR‐Allergic Rhinitis 2023 employed established evidence‐based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work. Results ICAR‐Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost. Conclusion The ICAR‐Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.

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“…Three recordings at each time point (Table 7) were performed and the highest value was used for analysis (62). The PNIF measurements were compared to the baseline value before the exposure on an individual basis, and a decrease in PNIF indicated an increased nasal obstruction (63).…”

Section: Medical Assessment Nasal Patency and Pulmonary Function Measuresmentioning

confidence: 99%

Effects of Renewable Diesel Exhaust on Lung Function and Self-rated Symptoms for Healthy Volunteers in a Human Chamber Exposure Study 

Gren

Dierschke

Mattsson

et al. 2021

Preprint

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Background: Diesel engine exhaust causes adverse health effects. Meanwhile, the impact of renewable diesel exhaust on human health is less known. In this study, nasal patency, pulmonary function, and self-rated symptoms were assessed in 19 healthy volunteers after two separate 3-hour exposures to renewable diesel (hydrotreated vegetable oil [HVO]) exhaust, and exposure to filtered air (FA) for comparison. The HVO exposures were generated with two modern non-road vehicles (2019) having either: 1) no aftertreatment system (HVOPM+NOx), or 2) an aftertreatment system containing a diesel oxidation catalyst and a diesel particulate filter (HVONOx). The exposure concentrations complied with current EU occupational exposure limits (OELs) of NO, NO2, formaldehyde, polycyclic aromatic hydrocarbons (PAHs), and future OELs of elemental carbon (EC) from 2023. Results: Exposure to HVOPM+NOx consisted of PM1 (≈90 µg m-3, 54 µg m-3 EC) and NOx (NO 3.4 ppm, NO2 0.6 ppm). The average total respiratory tract deposition of PM1 was 27 µg h-1. The deposition fraction of HVO PM1 was 40-50% higher compared to diesel exhaust PM1 from an older vehicle, due to smaller particle sizes of the HVOPM+NOx exhaust. Exposure to HVONOx consisted mainly of NOx (NO 2.0 ppm, NO2 0.7 ppm) with low level of PM1 (~1 µg m-3). Compared to filtered air, exposure to HVOPM+NOx and HVONOx caused higher incidence of self-reported symptoms (78%, 63%, respectively, vs. 28% for FA, p<0.03). Especially, exposure to HVOPM+NOx showed 40-50% higher eye and throat irritation symptoms. Compared to filtered air, a decrement in nasal patency was found for the HVONOx exposures (-18.1, 95%CI: -27.3 to -8.8 L min-1), and for the HVOPM+NOx (-7.4 (-15.6 to 0.8) L min-1). Overall, no change was indicated in the pulmonary function tests (spirometry, peak expiratory flow, forced oscillation technique), except a slight increase in FEV1/FVC after exposure to HVONOx.Conclusion: Short-term exposure to HVO exhaust below the EU OELs did not cause severe pulmonary function changes in healthy subjects. However, an increase in self-rated mild irritation symptoms, and mild decrease in nasal patency after two HVO exposures may indicate irritative effects from exposure to HVO exhaust from modern non-road vehicles below future OELs.

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Nasal Peak Inspiratory Flow in Healthy and Obstructed Patients: Systematic Review and Meta‐Analysis

Cited by 19 publications

References 40 publications

Lung function and self-rated symptoms in healthy volunteers after exposure to hydrotreated vegetable oil (HVO) exhaust with and without particles

Lung function and self-rated symptoms in healthy volunteers after exposure to hydrotreated vegetable oil (HVO) exhaust with and without particles

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

Effects of Renewable Diesel Exhaust on Lung Function and Self-rated Symptoms for Healthy Volunteers in a Human Chamber Exposure Study

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Nasal Peak Inspiratory Flow in Healthy and Obstructed Patients: Systematic Review and Meta‐Analysis

Cited by 19 publications

References 40 publications

Lung function and self-rated symptoms in healthy volunteers after exposure to hydrotreated vegetable oil (HVO) exhaust with and without particles

Lung function and self-rated symptoms in healthy volunteers after exposure to hydrotreated vegetable oil (HVO) exhaust with and without particles

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

Effects of Renewable Diesel Exhaust on Lung Function and Self-rated Symptoms for Healthy Volunteers in a Human Chamber Exposure Study&nbsp;

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Effects of Renewable Diesel Exhaust on Lung Function and Self-rated Symptoms for Healthy Volunteers in a Human Chamber Exposure Study