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Susceptibility to air pollution in elderly males and females

⁵ Municipal Health Service Amsterdam, Dept of Environmental Medicine, Amsterdam, and ² RAS, University of Utrecht, Utrecht, ¹ Dept of Epidemiology, University of Groningen, ³ Dept of Paediatric Pulmonology, and ⁴ Dept of Pulmonology, University Hospital Groningen, Groningen, The Netherlands

CORRESPONDENCE: H. M. Boezen, section Epidemiology, Faculty of Medical Sciences, University of Groningen, room P1.131 AZG, Hanzeplein 1, PO Box 30.001, 9700 RD Groningen, The Netherlands. Fax: 31 503633082. E-mail: h.m.boezen@med.rug.nl

Keywords: Air pollution, airway hyperresponsiveness, elderly, immunoglobulin E, sex, susceptibility

Received: June 23, 2004
Accepted January 10, 2005

It is important to know which individuals in the general population have increased susceptibility to air pollution. The aim of this study was to identify susceptible subgroups by studying airways hyperresponsiveness (AHR), high total immunoglobulin (Ig)E and sex.

Diary data on lower and upper respiratory symptoms (LRS and URS, respectively), cough, and morning and evening peak expiratory flow (PEF) were collected in 327 elderly patients (50–70 yrs) for a period of 3 months. Acute effects of particulate matter with a diameter <10 µm, black smoke, sulphur dioxide and nitrogen dioxide on symptoms and PEF were estimated using logistic regression.

In total, 48 (14.7%) subjects had AHR+/IgE+, 112 (34.3%) had AHR–/IgE+, 42 (12.8%) had AHR+/IgE– and 125 (38.2%) had AHR–/IgE–. In the AHR+/IgE+ group, each 10 µg·m^–3 increase in air pollution was associated with a significant increase in prevalence of URS (odds ratio ranging 1.03–1.19), cough (1.03–1.08) and fall in morning PEF (1.04–1.26). In the AHR+/IgE+ group, males responded predominantly with symptoms and females with a fall in morning PEF.

In conclusion, elderly individuals with both airway hyperresponsiveness and high total immunoglobulin E are especially susceptible to air pollution. Identifying susceptible subgroups might enlarge insight into the actual mechanisms by which air pollution evokes specific modes of response.

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				D. S. Postma and M. H. M. Boezen Peak expiratory flow monitoring in older patients with asthma: an aid to management? Am. J. Respir. Crit. Care Med., November 15, 2006; 174(10): 1065 - 1066. [Full Text] [PDF]