Technology for determining clinical-anamnestic markers of cold and osmotic airway hyperresponsiveness

Abstract

Introduction . The high labor intensity of instrumental tests to detect cold/osmotic hyperresponsiveness of the airways raises the question of finding alternative options for identifying individuals sensitive to cold air and high ambient humidity. Aim . Development and validation of questionnaires for the detection of cold and osmotic airway hyperresponsiveness. Materials and methods . A survey was conducted according to a specially developed questionnaire of 191 patients with mild and moderate persistent asthma in order to identify clinical symptoms of response to low temperature and high humidity of the environment in everyday life and after performing acute bronchoprovocation tests: 3-minute isocapnic hyperventilation with cold (-20ºC) air and 3-minute inhalation of ultrasonically nebulized distilled water. Results . The main clinical symptoms in individuals sensitive to cold and/or high environmental humidity are the occurrence of breathlessness and/or shortness of breath, coughing, labored breathing, distant wheezing under the influence of cold or moisture triggers. In individuals with cold airway hyperresponsiveness, a high predictive value was obtained for the “breathlessness/shortness of breath” symptom (sensitivity and specificity 88.2 and 86.9%). In individuals with osmotic airway hyperresponsiveness, a high predictive value included two symptoms – “breathlessness/shortness of breath”, “appearance of distant wheezing”(sensitivity and specificity 88.4 and 85.3%). On the basis of the data obtained, two screening questionnaires have been developed, containing keys for a quick diagnosis of cold and osmotic airway hyperresponsiveness. The questionnaires were tested on 840 respondents from the Amur Gas Processing Plant. Conclusion . The information provided is important for assessing the health of the population living in severe climatic conditions, the population of people involved in working in these regions. The proposed screening questionnaires can be used to develop prevention programs for people whose profession is associated with a high risk of respiratory infections when working in cold conditions or high humidity conditions.