Abstract
Information on potential cough triggers including environmental irritants is vital for successful management of chronic cough in patients. We investigated the relationship between ambient levels of particulate polycyclic aromatic hydrocarbons (PAH), nitrogen dioxide (NO2) and sulphur dioxide (SO2) exposures with cough prevalence. Eighty-three adult patients, who had been physician diagnosed with at least asthma, cough variant asthma and/or atopic cough, were divided into asthma and non-asthma groups. They recorded daily cough symptoms during 4 January–30 June 2011 study period while daily samples of total suspended particles were simultaneously collected by use of glass fiber filters and the particulate PAH content determined by high performance liquid chromatography coupled with a fluorescence detector. Ambient concentrations of NO2 and SO2 were obtained from a local monitoring site. Logistic regression models using generalized estimating equations were used to determine population-averaged estimates of association between cough prevalence and ambient pollutant exposures for the two groups. Fully adjusted odds ratios from single pollutant models were 1.083 (95% confidence interval (CI): 1.029, 1.140) and 1.097 (95% CI: 1.016, 1.185) per 0.57 ng/m3 for lag2 PAH exposure, while only for asthma group had significant associations with NO2 and SO2 exposures for both lag2 and lag02. Similar associations were observed in multipollutant models. This finding suggests that ambient PAH, NO2, and SO2 exposure even at low levels is related to cough prevalence in adult chronic cough patients and may be considered as aggravating factor during clinical management of the condition.
Highlights
The estimated prevalence of chronic cough is said to be affecting close to 10% of the general population [1,2,3]
A total of 11,913 participant-days were available for analysis from repeated measurements on 49 and 34 that were followed for 21–178 and 56–178 days for two groups respectively
While previous observational studies have assessed the relationship between ambient exposure to criteria pollutants on respiratory health among susceptible adults, there have been relatively few studies on cough symptoms associated with low level ambient polycyclic aromatic hydrocarbons (PAH) in addition to criteria pollutants
Summary
The estimated prevalence of chronic cough is said to be affecting close to 10% of the general population [1,2,3]. It is one of the reasons for seeking medical consultation with primary care or respiratory physician, and failure to satisfactorily control it may lead to decreased quality of life in some patients. Patients with chronic cough report a wide range of triggers, it is important to know the factors that might initiate as well as sustain the condition Such information will be invaluable in management of patients, alleviating the burden that is associated with the condition
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