Differences In Respiratory Symptoms Research Articles

Electronic cigarette use in relation to changes in smoking status and respiratory symptoms.

How e-cigarette use relates to changes in smoking status and respiratory symptoms in the population remains controversial. The aim was to study the association between e-cigarette use and, changes in smoking status and changes in respiratory symptoms. A prospective, population-based study of random samples of the population (age 16-69 years) was performed within The Obstructive Lung Disease in Northern Sweden (OLIN) study and West Sweden Asthma Study (WSAS). A validated postal questionnaire containing identical questions was used in OLIN and WSAS at baseline in 2006-2008 and at follow-up in 2016. In total, 17325 participated on both occasions. Questions about respiratory symptoms and tobacco smoking were included in both surveys, while e-cigarette use was added in 2016. In 2016, 1.6% used e-cigarettes, and it was significantly more common in persistent tobacco smokers (10.6%), than in those who quit smoking (2.1%), started smoking (7.8%), or had relapsed into tobacco smoking at follow-up (6.4%) (p<0.001). Among current smokers at baseline, tobacco smoking cessation was less common in e-cigarette users than e-cigarette non-users (14.2% vs 47.6%, p<0.001) and there was no association with a reduction in the number of tobacco cigarettes smoked per day. Those who were persistent smokers reported increasing respiratory symptoms. In contrast, the symptoms decreased among those who quit tobacco smoking, but there was no significant difference in respiratory symptoms between quitters with and without e-cigarette use. E-cigarette use was associated with persistent tobacco smoking and reporting respiratory symptoms. We found no association between e-cigarette use and tobacco smoking cessation, reduction of number of tobacco cigarettes smoked per day or reduction of respiratory symptoms.

Achalasia Subtype Differences Based on Respiratory Symptoms and Radiographic Findings.

Three subtypes of achalasia have been defined using esophageal manometry. Several studies have reported that symptoms are experienced differently among men and women, regardless of subtype. All subtypes could have some impact on the appearance of respiratory symptoms and lung complications due to compression of the trachea or aspiration of undigested food. The aim of this research was to analyze the differences in respiratory symptoms and radiographic presentation of lung pathology depending on the diameter and achalasia types. One or more respiratory symptoms were reported in 48% of 114 patients, and all of them had two or more gastrointestinal symptoms. The symptom score (SS) is statistically significant for the prediction of subtype 1 (area under the curve = 0.318; p < 0.001, cut-off score of 6.5 had 95.2% sensitivity) and subtype 2 (area under the curve = 0.626; p = 0.020, cut-off score of 7.5 had 93.1% sensitivity). The most common type was subtype 2 (50.8%), and although only 14 patients had subtype 3, they had the largest esophageal diameter (mean 5.8 cm). The difference in esophageal diameter was significant between subtype 1 and 3 (p = 0.011), subtype 2 and subtype 3 (p = 0.011). Nine patients (6%) had mega-esophagus (four patients in type 1, three in type 2 and two in type 3). More than half of all patients (51.7%) had at least one parenchymal lung change on CT scan. Recurrent micro-aspirations led to changes in the structure of the airways and lung parenchyma such as ground glass (GGO) and nodular changes (12%) and fibrosis (14.5%), and they had higher esophageal diameters (p < 0.001). Patients with chronic lung CT changes had significantly higher esophageal diameter than with acute changes (p < 0.001). Awareness of the association of achalasia and lung disorders is important in early diagnosis and treatment. More than half (57.5%) of patients with achalasia had some clinical and/or structural pulmonary abnormalities. All three subtypes had similar respiratory symptoms, meaning they cannot be used to predict the subtype of achalasia; on the contrary, SS can predict the first two subtypes. A higher diameter of the esophagus is associated with chronic structural lung changes. Although unexpected, the pathological radiological findings and diameter were significantly different in subtype 3 patients, but those parameters cannot lead us to a specified subtype.

COMPARATIVE STUDY OF CLINICO-RADIOLOGICAL AND MYCOBACTERIAL PROFILE OF PULMONARY TB IN DIABETIC VS. NON DIABETIC PATIENTS AT TERTIARY CARE HOSPITAL

Background: Tuberculosis (TB) is a disease most commonly affecting the lungs caused by mycobacterium tuberculosis, may also affect any parts of the body. Diabetes mellitus (DM) is recognized as a major risk factor for the progression of active pulmonary tuberculosis (PTB). The prole of pulmonary tuberculosis is variable in diabetic vs non diabetic patients .There is scarcity of published comparative literature, therefore this study carried out. This is hospital based prospective observational and comparative study was conducted in admitted patients of MahatmaMethod: Gandhi Medical College &amp; Hospital, Jaipur. All the new cases of pulmonary tuberculosis diagnosed on the basis of clinic-radiological and mycobacterial. All the tuberculosis patients were also screened for diabetes as per criteria and divided in 2 groups PTB-DM &amp; PTB-NDM respectively. Total number of cases of pulmonary tuberculosis in the study was 150, out of which 50 cases with diabetic and 100 casesResults: without diabetic. Male's predominance was in both the groups (70%vs78%). Maximum cases of PTB were in middle age (41-60 years) in both the groups (54% vs51%). There was no signicant difference in respiratory symptoms, mycobacterial positivity and various type parenchymal lesions. However there was signicantly more grade 3 positivity on Z.N staining, lower zone predominance, multiple cavitations and far advance disease in diabetic PTB patients Diabetes is a risk factor &amp; potentially may affect serious implications in management of tuberculosis and TB. Conclusion: control program. Therefore, early detection of diabetes in suspect cases of pulmonary tuberculosis &amp;vice-versa is important in clinical practice &amp; TB control program.

Respiratory symptoms do not reflect functional impairment in early CF lung disease

BackgroundLung disease can develop within the first year of life in infants with cystic fibrosis (CF). However, the frequency and severity of respiratory symptoms in infancy are not known. MethodsWe assessed respiratory symptoms in 50 infants with CF and 50 healthy matched controls from two prospective birth cohort studies. Respiratory symptoms and respiratory rate were documented by standardized weekly interviews throughout the first year. Infants performed multiple breath washout in the first weeks of life. ResultsWe analyzed 4552 data points (2217 in CF). Respiratory symptoms (either mild or severe) were not more frequent in infants with CF (OR:1.1;95% CI:[0.76, 1.59]; p=0.6). Higher lung clearance index and higher respiratory rate in infants with CF were not associated with respiratory symptoms. ConclusionsWe found no difference in respiratory symptoms between healthy and CF infants. These data indicate that early CF lung disease may not be captured by clinical presentation alone.

A Simple Theoretical Model for the Prevention of Respiratory Symptoms in Fine Dust Environments

This study is a simple theoretical model for the prevention of respiratory symptoms in fine dust environments. The study was conducted on 116 patients who visited the respiratory clinic in Seoul from March 6 to May 7. It was classified as 58 before the new system was applied and 58 after the system was applied. The data were surveyed in a structured questionnaire. The difference in respiratory symptoms through the new system is calculated by t-test. The main findings are as follows. Firstly, the sore throat has improved significantly since the application of the new information system (t=5.29, p=.000). Secondly, coughing decreased significantly when radish was consumed daily than when it was not consumed. Thirdly, the new environment system has reduced respiratory symptoms by 22%. Through this study, we believe that the new environmental system will contribute to the treatment of other diseases as well as respiratory diseases.

Clinical impact of forced vital capacity on exercise performance in patients with chronic obstructive pulmonary disease

BackgroundForced vital capacity (FVC) has been suggested to be a good biomarker for decreased exercise performance in patients with chronic obstructive pulmonary disease (COPD). However, as FVC is highly correlated with forced expiratory volume in 1 second (FEV1), the relationship between FVC and exercise capacity should be assessed within the category of FEV1, i.e., COPD severity. However, this was not considered in previous studies. Thus, limited data are available on the association between reduced FVC and exercise capacity measured by 6-min walk distance (6MWD) based on COPD severity.MethodsWe performed a cross-sectional study using data from the Korean COPD Subgroup Study (KOCOSS) cohort. We evaluated 1,386 patients with moderate (n=895) and severe-to-very severe (n=491) COPD. Reduced FVC was defined as FVC <80% predicted and short 6MWD as <350 m. Multivariable logistic regression was used to evaluate the association between reduced FVC and short 6MWD.ResultsThere were no significant differences in respiratory symptoms and quality of life between the patients with reduced FVC and those with preserved FVC. However, patients with reduced FVC had shorter 6MWD (30.5 cm in moderate and 34.5 cm in severe-to-very severe COPD) and higher BODE index scores than those with preserved FVC. The cubic spline model revealed 6MWD peaked around 93% predicted of FVC in moderate COPD, whereas FVC showed a positive association with 6MWD in severe-to-very severe COPD. Multivariable analyses showed that reduced FVC was significantly associated with short 6MWD in both moderate [adjusted odds ratio (aOR) =1.44, 95% confidence interval (CI): 1.03–2.02] and severe-to-very severe (adjusted OR =1.55, 95% CI: 1.01–2.40) COPD.ConclusionsReduced FVC was significantly associated with shorter 6MWD in moderate-to-very severe COPD patients, suggesting that reduced FVC might be reflective of 6MWD-measured exercise capacity in moderate-to-very severe COPD.

Alpha-1 antitrypsin deficiency is significantly associated with atopy in asthmatic patients

Background: Although the etiology and disease mechanisms of asthma and alpha-1 antitrypsin deficiency (AATD) are distinct, several reports indicate that asthma is common in AATD patients, however the relationships between asthma and AATD are poorly described in the literature. Objectives: The aim of the study was to investigate in a cohort of outpatients affected by mild to moderate asthma the clinical features that may differentiate asthmatic patients with and without mutation on SERPINA1 gene. Methods: Seven hundred thirty-five asthmatic outpatients underwent quantitative analysis of the serum level of alpha-1antitrypsin. According to the literature only sixty-seven out of seven hundred thirty-five asthmatic patients were submitted to genetic analysis to identify AATD and non-AATD subjects. Fifty-eight patients were studied. Clinical and functional data, including lung function, atopy and bronchial hyperactivity, were recorded. Results: The fifty-eight asthmatic patients were divided in AATD patients (n = 22) and non AATD patients (n = 36), according to genotype. The presence of atopy was significantly higher in patients with AATD than in those without AATD (91% vs. 64%; p = 0.031). AATD patients reported allergic manifestations more than non AATD patients (77% vs. 47%; p = 0.030). Conclusion: Our study shows that the presence of atopy in asthmatic patients with AATD is significantly higher than in asthmatic patients without gene mutation. In addition, a higher percentage of AATD patients self-reported allergic manifestations. No significant differences in respiratory symptoms, physical examination, disease severity or inflammation markers were found between AATD patients and non AATD patients.

Exclusive E-Cigarette Users Report Lower Levels of Respiratory Symptoms Relative to Dual E-Cigarette and Cigarette Users.

IntroductionExclusive e-cigarette use has been shown to be associated with reduced levels of respiratory symptoms relative to smoking combustible cigarettes; this association has been less frequently studied in smokers using advanced-generation e-cigarette devices. Advanced-generation devices generate denser vapor than either early generation or pod-style devices, and engender longer inhalations; these vaping topography patterns may contribute to respiratory symptoms.MethodsIn a single-session, cross-sectional study of exclusive e-cigarette users (N = 59) and dual users of e-cigarettes and cigarettes (N = 54), participants completed questionnaires, including the American Thoracic Society Questionnaire (ATSQ) and were videotaped vaping their own device in the lab for 1 hour. Using a hierarchical regression method, we examined whether topography variables, level of nicotine concentration used in their e-cigarette device in the past month, e-cigarette dependence, amount of e-cigarette use in the past month, and smoking status (any smoking in the last month vs. none) predicted ATSQ score severity.ResultsThere was a significant mean difference in ATSQ score across smoking status, with greater ATSQ scores for vapers who also smoked cigarettes (19.0, SD = 6.7) than for exclusive vapers (13.4, SD = 5.3). In the final model, of the predictors of interest, only cigarette smoking status predicted significantly greater ATSQ scores (overall F = 2.51, p = .006; R2 = .26; smoking status β = 0.39, p < .0001).ConclusionsFindings suggest that differences in respiratory symptoms between dual and exclusive e-cigarette users appear to be attributable to combustible cigarette smoking, rather than more intense or frequent e-cigarette use across groups.ImplicationsIn this comparison of exclusive advanced-generation vape device users (N = 59) versus dual users of these devices and combustible cigarettes (N = 54), we set out to determine the extent to which smoking status and e-cigarette use variables predicted self-reported respiratory symptom severity. We found that dual users showed greater respiratory symptom severity (ATSQ scores) than exclusive vapers. Despite examining vaping topography and other variables, smoking status and race were the only significant predictor of respiratory symptoms. We conclude that combustible cigarette use, not individual vaping topography, likely accounts for differences in respiratory symptoms between dual users and exclusive vapers.

Phenotypic features of ciliary dyskinesia among patients with congenital cardiovascular malformations.

Cilia are cell membrane-bound organelles responsible for airway mucus clearance, establishment of left-right organ asymmetry, cardiogenesis, and many other functions in utero. Phenotypic features suggestive of respiratory ciliary dyskinesia among patients with heterotaxy syndrome, defined as complex cardiovascular malformations (CVM) and situs ambiguus (SA), has not been adequately explored. We hypothesized that there is a greater incidence of phenotypic features consistent with ciliary dyskinesia among patients with heterotaxy syndrome compared to patients with other CVM and laterality defects without heterotaxy syndrome. Thirty six subjects were identified by medical record search and divided into four groups based on situs status and type of CVM as follows: SA and complex CVM (group 1); SA and simple CVM (group 2); situs solitus and complex CVM (group 3); and situs solitus and simple CVM (group 4). Phenotype was assessed with a clinical questionnaire, nasal nitric oxide (NO) level, and pulmonary function testing. Those with complex CVM underwent additional testing for variants in genes involved in ciliary structure and function. The mean nasal NO level was significantly lower among all subjects with complex CVM regardless of situs anomalies (groups 1 and 3). There was no significant difference in respiratory symptoms or lung function among the four groups. No bi-allelic genetic mutations were detected among patients with complex CVM. This study identified a relatively lower mean nasal NO level, suggestive of relative ciliary dyskinesia, among subjects with complex CVM. Pulmonary function and clinical symptoms did not reflect significant pulmonary disease among those with complex CVM.

Evaluation of respiratory health among refuse management and sanitation board workers in Kano metropolis

Context: Kano State Refuse Management and Sanitation board workers are constantly exposed to bioaerosol inhalation, including toxins and biotoxins that are been released from the waste. Aims: The aim of this study is to evaluate and determine the respiratory health status of Workers. Methodology: The study was a cross-sectional survey with 129 participants recruited using a convenience sampling technique. Forced vital capacity, forced expiratory volume in 1 s and St. George questionnaire were used to collect data and the result was analysed using descriptive statistics of frequencies, percentages and graphs, while the differences and relationships were obtained using one-way ANOVA and Spearman rank correlation co-efficient, respectively. Results: The mean age of the participants was 34.2 years. Up to 75.2% of the participants were male, whereas 24.8% were female. Up to 40% of participants did not have any respiratory symptoms, 35% had mild symptoms, 14% had moderate symptoms and 11% had severe respiratory symptoms. The symptoms include dyspnea, coughing, excessive mucus secretion and breathlessness. Respiratory symptoms was positively related to the length of exposure (P = 0.029). There was no significant difference in respiratory symptoms between waste collectors, sweepers and drivers. Furthermore, no relationship was found between the age of the workers and respiratory symptom (P = 0.056). Significant difference (P = 0.003) was observed between gender of the participants and respiratory health. Conclusions: Waste disposal work has significant impact on respiratory health. The provision of health education for safety and proper use of personal protection is necessary to reduce the impact of pollutant on respiratory health.

Prevalence of Respiratory Health Symptoms among Landfill Waste Recyclers in the City of Johannesburg, South Africa

In developing countries, waste sorting and recycling have become a source of income for poorer communities. However, it can potentially pose significant health risks. This study aimed to determine the prevalence of acute respiratory symptoms and associated risk factors for respiratory health outcomes among waste recyclers. A cross-sectional study was conducted among 361 waste recyclers at two randomly selected landfill sites in Johannesburg. Convenience sampling was used to sample the waste recyclers. The prevalence of respiratory symptoms in the population was 58.5%. A persistent cough was the most common symptom reported (46.8%), followed by breathlessness (19.6%) and rapid breathing (15.8%). Approximately 66.4% of waste recyclers reported exposure to chemicals and 96.6% reported exposure to airborne dust. A multivariable logistic regression analysis showed that exposure to waste containing chemical residues (OR 1.80, 95% CI 1.01–3.22 p = 0.044) increased the odds of respiratory symptoms. There was a significant difference in respiratory symptoms in landfill sites 1 and 2 (OR 2.77, 95% CI 1.03–7.42 p = 0.042). Occupational health and safety awareness is important to minimize hazards faced by informal workers. In addition, providing waste recyclers with the correct protective clothing, such as respiratory masks, and training on basic hygiene practices, could reduce the risks associated with waste sorting.

The Differences of Respiratory Symptoms and Pulmonary Impairment between Exposure and Unexposured Areas by Dust from Semen Padang Factory

Background: The cement factories have a waste product such as dust that had negative impact on respiratory system. The aims of this&#x0D; study is to investigate the differences of respiratory symptoms and pulmonary impairment between exposure and unexposured region by dust&#x0D; from Semen Padang factory.&#x0D; Methods: Cross sectional study of 282 subjects from exposure and unexposure areas in Semen Padang factory. This study was held in&#x0D; March 2016 - July 2017. Dust levels were assessed at both areas. Respiratory symptoms were assessed by interviews and quistionnaires.&#x0D; Lung function was measured by spirometry examinations. The variables between both groups were analyzed.&#x0D; Results: The daily dust level of exposure area close to three folds than unexposure area (150μg/Nm 3 vs 53,50 μg/Nm 3) yet still in save level&#x0D; that assigned by regulation. There were 282 subjects from both areas which consist of 67 men and 74 women for each area. There were no&#x0D; differences in respiratory symptoms included chest pain (0% vs 0,7%, P=1,00), productive cough (4,3% vs 2,1%, P=0,5), cronic cough (4,3%&#x0D; vs 2,1% ,P=0,5) and breathlessness (5,7% vs 5% ,P=1,00). The proportion of pulmonary impairment not difference between two areas (P=0,053).&#x0D; Concusions: Both area had dust level below up level assigned by regulation. There were no differences in respiratory symptoms and&#x0D; pulmonary impairment at exposure area and unexposure area. Breathlessness is most common symptom.

Differences in Respiratory Symptoms and Lung Structure Between Hispanic and Non-Hispanic White Smokers: A Comparative Study.

Background: Prior studies have demonstrated that U.S. Hispanic smokers have a lower risk of decline in lung function and chronic obstructive pulmonary disease (COPD) compared with non-Hispanic whites (NHW). This suggests there might be racial-ethnic differences in susceptibility in cigarette smoke-induced respiratory symptoms, lung parenchymal destruction, and airway and vascular disease, as well as in extra-pulmonary manifestations of COPD. Therefore, we aimed to explore respiratory symptoms, lung function, and pulmonary and extra-pulmonary structural changes in Hispanic and NHW smokers. Methods: We compared respiratory symptoms, lung function, and computed tomography (CT) measures of emphysema-like tissue, airway disease, the branching generation number (BGN) to reach a 2-mm-lumen-diameter airway, and vascular pruning as well as muscle and fat mass between 39 Hispanic and 39 sex-, age- and smoking exposure-matched NHW smokers. Results: Hispanic smokers had higher odds of dyspnea than NHW after adjustment for COPD and asthma statuses (odds ratio[OR] = 2.96; 95% confidence interval [CI] 1.09-8.04), but no significant differences were found in lung function and CT measurements. Conclusions: While lung function and CT measures of the lung structure were similar, dyspnea is reported more frequently by Hispanic than matched-NHW smokers. It seems to be an impossible puzzle but it's easy to solve a Rubik' Cube using a few algorithms.

Restrictive Pattern of Pulmonary Symptoms among Photocopy and Printing Workers: A Retrospective Cohort Study.

According to the growth of photocopier usage in workplaces, the potential risk of occupational exposure to the airborne chemicals has been raised up. Hence, monitoring the photocopy worker's respiratory functions seems to be necessary. We aimed to evaluate the respiratory health on photocopy and printing workers so that a reliable description can be made about their occupational hygiene. This study was performed in Shiraz, southwest Iran in 2014 and a group of 150 photocopy and printing workers were surveyed as exposed group in addition to a group of 114 office staff as unexposed group. The respiratory standard questionnaire was used to evaluate the prevalence of respiratory symptoms among the selected staff. Pulmonary function indexes including VC, FVC, FEV1 and the FEV1/FVC ratio were calculated. Finally, t-test, Chi Square and multiple logistic regressions were conducted. VC, FVC and FEV1 in photocopy and printing workers were lower than the unexposed group of which these differences for FVC and FEV1 were statistically significant (P<0.05). Moreover, the prevalence of all respiratory symptoms, except the shortness of breath, in exposed group was more than the unexposed group and the prevalence of coughing and wheezing was statistically significant (P<0.05). There was a significant difference in respiratory symptoms (cough and wheezing) between two groups after controlling for confounding variables, OR: 2.61 (95% CI: 1.21, 5.62) and 2.92 (95% CI: 1.25, 6.84), respectively. The prevalence of excess respiratory symptoms along with pattern of pulmonary restrictive sings in photocopy and printing workers revealed that the workplace conditions can result in occupational respiratory diseases.

Safety risks for patients with aspirin-exacerbated respiratory disease after acute exposure to selective nonsteroidal anti-inflammatory drugs and COX-2 inhibitors: Meta-analysis of controlled clinical trials

Nonsteroidal anti-inflammatory drugs (NSAIDs) cause bronchospasm in susceptible patients with asthma, often termed aspirin-exacerbated respiratory disease (AERD), with the risk being greatest after acute exposure. Selective NSAIDs that preferentially inhibit COX-2 might be safer. We sought to systematically evaluate changes in symptoms and pulmonary function after acute selective NSAID or COX-2 inhibitor exposure in patients with the AERD phenotype. A systematic review of databases was performed to identify all blinded, placebo-controlled clinical trials evaluating acute selective NSAID or COX-2 inhibitor exposure in patients with AERD. Effect estimates for changes in respiratory function and symptoms were pooled by using fixed-effects meta-analysis, with heterogeneity investigated. No significant difference in respiratory symptoms (risk difference, -0.01; 95% CI, -0.03 to 0.01; P = .57), decrease in FEV1 of 20% or greater (RD, 0.00; 95% CI, -0.02 to 0.02; P = .77), or nasal symptoms (RD, -0.01; 95% CI, -0.04 to 0.02; P = .42) occurred with COX-2 inhibitors (eg, celecoxib). Selective NSAID exposure caused respiratory symptoms in approximately 1 in 13 patients with AERD (RD, 0.08; 95% CI, 0.02 to 0.14; P = .01). No significant differences were found according to leukotriene antagonist exposure or whether NSAIDs were randomly allocated. According to clinical trial evidence in patients with stable mild-to-moderate asthma with AERD, acute exposure to COX-2 inhibitors is safe, and selective NSAIDs exhibit a small risk. Thus COX-2 inhibitors could be used in patients with AERD or in patients with general asthma unwilling to risk nonselective NSAID exposure when oral challenge tests are unavailable.

Sex-related differences in respiratory symptoms: results from the BOLD Study

For the same degree of lung function impairment females tend to report more (severe) dyspnoea and cough, but less phlegm http://ow.ly/mp2CF

Pulmonary Health Effects in Gulf War I Service Members Exposed to Depleted Uranium

In a population of Gulf War I veterans who sustained inhalational exposure to depleted uranium during friendly fire incidents in 1991, we evaluated whether those with high body burdens of uranium were more likely to have pulmonary health abnormalities than those with low body burdens. We compared self-reported respiratory symptoms, mean pulmonary function values, and prevalence of low-dose chest computed tomography abnormalities between high and low urine uranium groups. We found no significant differences in respiratory symptoms, abnormal pulmonary function values, or prevalence of chest computed tomography abnormalities between high and low urine uranium groups. Overall, the cohort's pulmonary function values fell within the expected clinical range. Our results support previous estimates that the depleted uranium levels inhaled during the 1991 friendly fire incidents likely do not cause long-term adverse pulmonary health effects.

Feather bedding and childhood asthma associated with house dust mite sensitisation: a randomised controlled trial

IntroductionObservational studies report inverse associations between the use of feather upper bedding (pillow and/or quilt) and asthma symptoms but there is no randomised controlled trial (RCT) evidence assessing the role...

Do spirometry and regular follow‐up improve health outcomes in general practice patients with asthma or COPD? A cluster randomised controlled trial

To determine whether spirometry with regular medical review improves the quality of life or other health outcomes among patients with asthma or chronic obstructive pulmonary disease (COPD) managed in general practice. Cluster randomised controlled trial conducted in 31 general practices in Melbourne during 2007-2008. Practices recruited 305 adult patients who had been prescribed inhaled medication in the preceding 6 months. Practices were randomly assigned to one of three groups: Group A patients received 3-monthly spirometry performed by a respiratory scientist with results returned to the practice and regular medical review; Group B patients received spirometry only before and after the trial; and Group C patients received usual care. Quality of life, assessed with the 36-item Short Form (SF-36) Australian (English) Version 2 questionnaire at baseline and 3, 6, 9 and 12 months. Secondary outcomes were assessed with the European Community Respiratory Health Survey at baseline and 12 months. The trial was completed by 253 participants: 79 in Group A, 104 in Group B, and 70 in Group C. Median age was 58 years (range, 18-70 years), and 167 participants (66%) were women. There were no significant changes in SF-36 Physical and Mental Component Summary scores from baseline to 12 months, or significant differences between groups on either scale or any subscale of the SF-36. There were also no significant differences in respiratory symptoms, asthma attacks, written asthma action plans, days lost from usual activities or health care utilisation. Three-monthly spirometry and regular medical reviews by general practitioners are not associated with any significant improvement in quality of life or other health outcomes for patients with asthma and/or COPD. Australian New Zealand Clinical Trials Registry ACTRN12606000378527.

Assessment of intra-urban variability in indoor air quality and its impact on children’s health

The results from a number of studies suggest that children living close to busy roads may have impaired respiratory health. The study reported here was designed specifically to test the hypothesis that exhaust from traffic has an impact on indoor air quality and children’s respiratory health. Children living at three different locations in a suburban area in India were enrolled in the study, and the concentrations of indoor air quality parameters were measured at selected households during the period March 2006–February 2007 using portable air quality monitors. Respiratory symptoms were identified by means of a questionnaire completed by parents and from the results of a pulmonary function test (PFT) carried out using an electronic Spiro Meter. The logistic regression model revealed associations between respiratory symptoms and traffic-related indoor air pollutants among our study population. The prevalence of respiratory disorders was greater among children living in close proximity to traffic sources than among those living more distant from these sources, even after the adjustment of confounding factors. We also found intra-urban variability of indoor air quality and associated differences in respiratory symptoms. Our findings support the hypothesis that traffic has an impact on indoor air quality and that it is associated with children’s health. The findings from this study have important policy and program implications, including the need for public information campaigns designed to inform people about the risks of exposure to traffic exhausts.