Association of traffic air pollution and rhinitis quality of life in Peruvian children with asthma

<div><p>Background</p><p>Air pollution exposure may contribute to rhinoconjunctivitis morbidity in children with underlying airways disease. Prior studies have not assessed rhinoconjunctivitis-related quality of life (QOL) in children with asthma chronically exposed to air pollution.</p><p>Methods</p><p>Children ages 9–19 years with asthma from peri-urban Peru, self-reporting rhinoconjunctivitis symptoms (n = 484), were administered the Rhinoconjunctivitis QOL Questionnaire (RQLQ) at repeated intervals over one year, with scores dichotomized into bothered (>0) and not bothered (= 0). Individual weekly exposures to particulate matter<2.5μm (PM_2.5) and its black carbon (BC) component were estimated by inverse distance weighted methods. Generalized estimating equations, adjusting for covariates, estimated associations of PM_2.5 and BC with QOL.</p><p>Results</p><p>Participants were on average 13 years old, 55% female, and majority were atopic (77%). Mean (SD) PM_2.5 and BC concentrations were 21(3.2) μg/m3 and 4.4(1.5) μg/m3, respectively. In adjusted multi-pollutant models, each 10μg/m3 increase in PM_2.5 was associated with increased odds of worse rhinoconjunctivitis QOL (OR;[95% CI]: 1.83;[1.33,2.52]). A 10% increase in the BC proportion was associated with higher rhinitis burden (OR;[95% CI]: 1.80;[1.22,2.66]), while increases in the non-BC component of PM did not significantly impact rhinoconjunctivitis QOL. Associations were similar regardless of atopy.</p><p>Conclusion</p><p>Higher PM2.5 and BC exposure is associated with worse rhinitis QOL among asthmatic children.</p></div

Unadjusted and adjusted¹ single and multipollutant logistic regression analyses evaluating the association of PM_2.5 and black carbon with rhinoconjunctivitis quality of life in young children and adolescents residing in Pampas and Villa, Peru.

<p>Unadjusted and adjusted¹ single and multipollutant logistic regression analyses evaluating the association of PM_2.5 and black carbon with rhinoconjunctivitis quality of life in young children and adolescents residing in Pampas and Villa, Peru.</p

Baseline demographic and clinical characteristics of asthmatic children overall and by site.

<p>Baseline demographic and clinical characteristics of asthmatic children overall and by site.</p

A pilot feeding study for adults with asthma: The healthy eating better breathing trial

<div><p>Rationale</p><p>Evidence from observational studies and to a lesser extent clinical trials suggest that a healthy diet may improve symptoms and lung function in patients with asthma. We conducted a pilot study to determine the feasibility of conducting a larger scale dietary trial and to provide preliminary evidence on the impact of a healthy diet on asthma outcomes.</p><p>Methods</p><p>In a randomized, two period cross-over trial, participants with asthma received a 4-week dietary intervention followed by a usual diet (or vice versa), separated by a 4-week washout. The dietary intervention was a healthy diet rich in unsaturated fat. During the dietary intervention, participants ate three meals per week on site at the Johns Hopkins ProHealth Research Center. All remaining meals and snacks were provided for participants to consume off-site. During the control diet, participants were instructed to continue their usual dietary intake. Relevant biomarkers and asthma clinical outcomes were assessed at 0, 2, and 4 weeks after starting each arm of the study.</p><p>Results</p><p>Eleven participants were randomized, and seven completed the full study protocol. Among these seven participants, average age was 42 years, six were female, and six were African American. Participant self-report of dietary intake revealed significant increases in fruit, vegetable, and omega-3 fatty acid intake with the dietary intervention compared to usual diet. Serum carotenoids (eg. lutein and beta-cryptoxanthin) increased in the intervention versus control. Total cholesterol decreased in the intervention versus control diet. There was no consistent effect on asthma outcomes.</p><p>Conclusions</p><p>The findings suggest that a feeding trial in participants with asthma is feasible. Larger trials are needed to definitively assess the potential benefits of dietary interventions on pulmonary symptoms and function in patients with asthma.</p></div

Participant characteristics.

<p>Participant characteristics.</p

Change in asthma morbidity outcomes.

<p>Change in asthma morbidity outcomes.</p

Participant-Reported dietary intake from 24 Hour dietary recalls.

<p>Participant-Reported dietary intake from 24 Hour dietary recalls.</p

Select asthma morbidity outcomes.

<p>Data in each graph represent the change in value from week 0 to week 4 of the control diet and the change in value from week 0 to week 4 of the intervention diet. Points are linked by lines connecting responses within individual participants.</p

Change in serum markers of adherence.

<p>Change in serum markers of adherence.</p

Consort diagram.

<p>Participants screened and enrolled.</p