BackgroundEnvironmental pollution is a known risk factor for multiple diseases and furthermore increases rate of hospitalisations. We investigated the correlation between emergency room admissions (ERAs) of the general population for respiratory diseases and the environmental pollutant levels in Milan, a metropolis in northern Italy.MethodsWe collected data from 45770 ERAs for respiratory diseases. A time-stratified case-crossover design was used to investigate the association between air pollution levels and ERAs for acute respiratory conditions. The effects of air pollutants were investigated at lag 0 to lag 5, lag 0–2 and lag 3–5 in both single and multi-pollutant models, adjusted for daily weather variables.ResultsAn increase in ozone (O3) levels at lag 3–5 was associated with a 78% increase in the number of ERAs for asthma, especially during the warm season. Exposure to carbon monoxide (CO) proved to be a risk factor for pneumonia at lag 0–2 and in the warm season increased the risk of ERA by 66%. A significant association was found between ERAs for COPD exacerbation and levels of sulphur dioxide (SO2), CO, nitrate dioxide (NO2), and particulate matter (PM10 and PM2.5). The multipollutant model that includes all pollutants showed a significant association between CO (26%) and ERA for upper respiratory tract diseases at lag 0–2. For chronic obstructive pulmonary disease (COPD) exacerbations, only CO (OR 1.19) showed a significant association.ConclusionsExposure to environmental pollution, even at typical low levels, can increase the risk of ERA for acute respiratory diseases and exacerbation of obstructive lung diseases in the general population.

Proceedings of the European Seminars in Respiratory Medicine course, Inhalation therapy in the next decade: Determinants of adherence to treatment in asthma and COPD, held in Taormina, Italy, on 3-4 March, 2017

In nine healthy and young subject of either sex, undergoing three or four rounds of muscular exercise of increasing severity on a bicycle ergometer, the authors investigated the behavior of the lung transfer factor (DL_CO), pulmonary ventilation (V), alveolar ventilation (Va), and cardiac output (Q). In all instances they found a positive linear correlation between DL_CO and oxygen consumption (VO₂), at least up to 70 % of maximum oxygen consumption (VO_2max) (r = 0.935; p < 0.001). Dl_CO was found to increase linearly as a function of increasing V (r = 0.898; p < 0.001) and even more so of increasing Va (r = 0.919; p < 0.001). Also the relationship between Dl_CO and Q appeared linear in all subjects (r = 0.926; p < 0.001). On the other hand, individual DL_CO values showed considerable scatter at equal VO₂, V, V_A, and Q values. Among the factors responsible for the increase of DL_CO during muscular exercise, in addition to increased ventilation and cardiac output, the authors suggest the possible role of the greater desaturation of mixed venous blood and variations of hemoglobin affinity for CO.

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