Risk of Childhood Allergy and Atopic Diseases Increased by Traffic Pollution

The risk of childhood allergy and atopic diseases is increased 50% by traffic-related pollution, according to a recent study by a German research organization.

“Children living very close to a major road are likely to be exposed not only to a higher amount of traffic-derived particles and gases but also to more freshly emitted aerosols which may be more toxic,” writes Dr. Heinrich. He continued: “Our findings provide strong evidence for the adverse effects of traffic-related air pollutants on atopic diseases as well as on allergic sensitization.”

The study’s author, Joachim Heinrich, Ph.D., of the German Research Center for Environment and Health at the Institute of Epidemiology, in Munich, checked close to 2900 children aged 4, and more than 3000 children aged 6 to establish their rates of asthma and allergy in relation to longterm exposure to traffic-related pollution.

Both groups of children came from the Munich area, and their exposure to traffic pollutants was calculated on the basis opf their homes’ distance from major roads at birth, and at two, three and six years of age. The parents completed questionnaires documenting their child’s respiratory symptoms and diagnoses, and the children were evaluated for asthma, wheezing, sneezing and eczema. The children were checked for food allergies at age six, and air was tested for particulate matter nd nitrogen dioxide at 40 high traffic areas between 1999 and 2000.

Significant positive associations were found between the distance to the nearest road and incidence of asthmatic bronchitis, hay fever, eczema and allergic sensitizations. Also noted was a relationship between proximity to a road and risk of allergic sensitization—subjects living closest to major roads had an almost 50% greater risk of allergic sensitization.

In this study, it was possible to determine that economic factors were not a confounding variable in the analysis, but there was a clear difference in the children’s allergic development with relation to their proximity to a road.

Source: American Journal of Respiratory and Critical Care Medicine, June, 2008 (2nd ed)

Lung Damage Evident 25 Years After Workers Exposed to Legal Limits of Asbestos-Like Material (Vermiculite)

Workers who processed vermiculite tainted with asbestos-like fibers 25 years ago show high prevalence of scarring and thickening of the membrane that lines the chest wall, including people exposed below legal levels.

In 1970 workers who had handled "Libby vermiculite" (so named after the Libby, Montana mine where the tainted fibers were first noted), exhibited a cluster of bloody pleural effusions. The Libby mine at one time produced up to 80 percent of the vermiculite used around the world.

513 former workers at a plant that processed Libby vermiculite were checked by researchers in 1980, and pleural changes or interstitial fibrosis were found in 2.2 percent of them. A team led by James Lockey, M.D., the principal investigator of this report, found that the unadjusted prevalence in the still-living members of the original cohort was 28.7 percent for pleural changes and 2.9 percent for interstitial fibrosis. The findings are published in the second issue for March of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

"I expected to see a higher rate of x-ray changes, but was surprised at the percentage," said. Dr. Lockey. "We found that even low levels of exposure to asbestos-like fibers can cause thickening of the membrane that lines the chest wall."

280 workers of the 431 workers stlll living were interviewed for the follow-up study, to determine their lung health and work history, as well as their exposure level and the number of years worked. Chest X-rays were reviewed by professional radiologists for pleural plaques, thickening and interstitial changes.

A significant trend of increasing changes with increased exposure was detected by researchers analyzing workers with pleural changes. Those with the highest exposure levels had an average of 6 to 16 times the risk of pleural changes compared with those minimally exposed. Equally important, changes were significant at levels permitted by law.

The findings indicate that "a significant number of workers exposed at the current limit would experience pleural abnormalities," wrote Gregory Wagner, M.D., of the National Institute for Occupational Safety and Health, in an accompanying editorial. Furthermore, regulations governing legal exposure limits to hazardous materials apply only to specific fibers, not to all types of fibers that have similar and predictable biological effects.

"When humans are exposed to any mineral fibers that are long, thin and durable in human tissue and can reach the pleural membrane, these fibers can cause health problems," said Dr. Lockey. "Six types of asbestos are currently regulated, but other existing types of fibers that share similar characteristics are not."Perhaps most importantly, the research highlights the need to anticipate the health implications of occupational exposures.

"The initial Lockey investigation found a relatively modest prevalence of pleural abnormalities," wrote Dr. Wagner. But the current study "found over 10 times that level, despite the fact that contaminated vermiculite had been removed from the production process by 1980."

Consumers encountered minimal risk from most products containing Libby vermiculite, said Dr. Lockey, but advised that any home improvements that involve contact with vermiculite insulation should be left to professionals.

Source: American Journal of Respiratory and Critical Care Medicine, March, 2008 (second issue).

Adult Illness and Death Risk Increased by Respiratory Disease During Childhood

Respiratory disease in childhood increases the risk of illness and premature death in adulthood, according to a study published in the journal, Thorax.

Between 1948 and 1968 10,000 male graduates of Glasgow University supplied researchers with details of childhood illnesses, including bronchitis, asthma and pneumonia, plus their weight, height and blood pressure.

When survivors of the original study were traced between 1998 and 2002, 4044 men out of 8410 replied. Victims of bronchitis, pneumonia asthma in early childhood were 57% more likely to die of respiratory disease than those who had not suffered from these illnesses as children. And they were more than twice as likely to die of chronic obstructive pulmonary disease, emphysema and bronchitis.

Men who had had bronchitis were also 38% more likely to die of cardiovascular disease. Respiratory illness during childhood was also associated with a higher risk of assorted respiratory problems in adulthood, ranging from the relatively minor to the severe.

Source: Thorax,/em> 2008; doi 10.1136/thx.2007.086744

Probiotics Reduces Respiratory Illness Rates in Athletes, Says Study

A study in the British Journal of Sports Medicine finds that the rate and length of respiratory illness in distance runners is substantially cut by the probiotic Lactobacillus. The normal immune response to colds and flu can be suppressed by heavy exercise, which can leave some athletes vulnerable to them.

Twenty elite athletes took three freeze-dried capsules twice daily of the probiotic Lactobacillus fermentum or a placebo, during four months of winter training. Lactobacillus is a lactic acid bacteria that has been used in the treatment of gut infections. Treatments lasted four weeks each, interspersed by a month of nothing, so that by the end of the period all athletes had taken both the probiotic and placebo.

Respiratory tract infections were assessed, together with treadmill performance, immune response. While there was no difference in performance between between athletes taking the probiotic and placebo, athletes taking the probiotic had less that half the number of days of symptoms of the athletes taking the placebo. Specifically, respiratory symptoms while taking Lactobacillus lasted 30 days compared with 72 days for those taking the placebo. Levels of interferon gamma were doubled by the probiotic, an important element of the body’s immune response.

"Probiotics seem to increase systemic immunity, possibly by boosting the activity of T cells", say the researchers. "The potential of this probiotic to be used as a treatment to ward off illness merits further investigation", they say.

"An improvement in resistance to common illnesses constitutes an important benefit to elite athletes undertaking high level training in preparation for national and international competitions," they conclude.

Source: British Journal of Sports Medicine (First Br J Sports Med 2008; doi 10.1136/bjsm.2007.044628)

Surprising Statin Finding: Slowing the Decline in Lung Functioning

In a recent paper published by the American Thoracic Society (October 2007), the use of statins appears to slow down the rate in which lung function declines in the senior population. More surprisingly, the decline decrease also is evident in smokers.

The researchers postulate that statins’ known anti-inflammatory properties (along with antioxidant properties) cause this effect.

Dr. Joel Schwartz, the lead researcher on the study, and a professor of environmental epidemiology at Harvard School of Public health, points out that his study shows the importance of "a possibility of reducing the rate of decline."

The primary indication for prescription of statins such as Lipitor and Zocor is for the treatment of high cholesterol.

Source: American Thoracic Society  

Steroids of No Help to Babies with Breathing Problems

According to a report by the New England Journal of Medicine, a steroid popularly prescribed to babies with breathing problems—particularly lower respiratory infections or Bronchiolitis—is not helpful.

One of the main causes of infant hospitalization is lower respiratory tract infection. During the study, one half of the babies were given steroids and the other half was treated with placebo medicine. None of the two treatments gave good results and 40 percent of babies from both the groups had to be hospitalized again.