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Association between the Ratio of FEV 1 to FVC and the Exposure Level to Air Pollution in Neversmoking Adult Refractory Asthmatics Using Data Clustered by Patient in the Soonchunhyang Asthma Cohort Database

Author

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  • Sol Yu

    (Department of Environmental Sciences, Soonchunhyang University, Asan 31538, Korea
    Division of Environmental Health Research, National Institute of Environmental Research, Incheon 22689, Korea)

  • Sujung Park

    (Department of Environmental Sciences, Soonchunhyang University, Asan 31538, Korea)

  • Choon-Sik Park

    (Department of Internal Medicine, Soonchunhyang Bocheon Hospital, Bucheon 22972, Korea)

  • Sungroul Kim

    (Department of Environmental Sciences, Soonchunhyang University, Asan 31538, Korea)

Abstract

Using real-world cases, asthma-related clinical data were clustered by patient; 5% of all asthmatics were found to have refractory asthma (RA) with a relatively low lung function (forced expiratory volume in 1 s/forced vital capacity (FEV 1 /FVC) less than 80%). Using a multilevel study design for clustered spirometry data observed between 2005 and 2014, we evaluated the association between changes in the ratio of FEV 1 to FVC and variations in acute exposure to air pollution. We analyzed 2310 episodes of RA from 214 neversmoking patients. In spring, a 1 µg/m³ increase in concentration of particles ≤10 μm (PM 10 ) on Lag 1 significantly reduced the ratio by 0.4% (95% confidence interval (CI): 0.1–0.7%) after adjusting for sex, age, body mass index (BMI), and total Immunoglobulin E (IgE) level. Unit (ppb) increase in SO 2 concentration on Lag 3 and 4 in fall and on Lag 6 in winter significantly reduced the ratio by 2 to 3% ( p < 0.05). We found that acute exposure to PM 10 in spring or SO 2 in fall or winter were positively associated with lung function drop indicating necessity of control strategies of target air pollutant source by season to protect susceptible population.

Suggested Citation

  • Sol Yu & Sujung Park & Choon-Sik Park & Sungroul Kim, 2018. "Association between the Ratio of FEV 1 to FVC and the Exposure Level to Air Pollution in Neversmoking Adult Refractory Asthmatics Using Data Clustered by Patient in the Soonchunhyang Asthma Cohort Dat," IJERPH, MDPI, vol. 15(11), pages 1-11, October.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:11:p:2349-:d:178037
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    References listed on IDEAS

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    1. Pablo Orellano & Nancy Quaranta & Julieta Reynoso & Brenda Balbi & Julia Vasquez, 2017. "Effect of outdoor air pollution on asthma exacerbations in children and adults: Systematic review and multilevel meta-analysis," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-15, March.
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    Cited by:

    1. Angelica I. Tiotiu & Plamena Novakova & Denislava Nedeva & Herberto Jose Chong-Neto & Silviya Novakova & Paschalis Steiropoulos & Krzysztof Kowal, 2020. "Impact of Air Pollution on Asthma Outcomes," IJERPH, MDPI, vol. 17(17), pages 1-29, August.
    2. Sungroul Kim & Jungeun Lee & Sujung Park & Guillaume Rudasingwa & Sangwoon Lee & Sol Yu & Dae Hyun Lim, 2020. "Association between Peak Expiratory Flow Rate and Exposure Level to Indoor PM2.5 in Asthmatic Children, Using Data from the Escort Intervention Study," IJERPH, MDPI, vol. 17(20), pages 1-11, October.

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