Dr. Fernando Holguin, at the University of Pittsburgh, Pennsylvania, and colleagues studied 85 asthmatic children, ages 7 to 12, living in Mexico City, where traffic-related air pollution is usually very high, 53 of whom had mild intermittent asthma, 20 mild persistent asthma, and 12 moderate persistent asthma, to determine whether outdoor air pollution had any impact on how well their rescue inhalers worked.
The team found that higher levels of certain air pollutants, specifically nitrogen dioxide and ozone, made the rescue inhalers less effective - not because the devices didn't function properly, but because the children did not seem to respond as well to the medication. An increase of 10 parts-per-billion in nitrogen dioxide levels in the air, for example, seemed to decrease rescue inhaler efficacy by about 15%. (Current nitrogen dioxide levels in the US average from 10 to 20 parts per billion.)
However, inhaled steroids provided some protection against the effects of pollution. For the 25 children in the study who regularly used inhaled corticosteroids to help control persistent asthma, the rescue inhalers provided more effective quick relief.
Chest, December 2009.
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First Published December 2009 12/09
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