Mucociliary clearance, airway inflammation and nasal symptoms in urban motorcyclists

Abstract

OBJECTIVES:There is evidence that outdoor workers exposed to high levels of air pollution exhibit airway inflammation and increased airway symptoms. We hypothesized that these workers would experience increased airway symptoms and decreased nasal mucociliary clearance associated with their exposure to air pollution.METHODS:In total, 25 non-smoking commercial motorcyclists, aged 18-44 years, were included in this study. These drivers work 8-12 hours per day, 5 days per week, driving on urban streets. Nasal mucociliary clearance was measured by the saccharine transit test; airway acidification was measured by assessing the pH of exhaled breath condensate; and airway symptoms were measured by the Sino-nasal Outcome Test-20 questionnaire. To assess personal air pollution exposure, the subjects used a passive-diffusion nitrogen dioxide (NO2) concentration-monitoring system during the 14 days before each assessment. The associations between NO2 and the airway outcomes were analyzed using the Mann-Whitney test and the Chi-Square test. Clinicaltrials.gov: NCT01976039.RESULTS:Compared with clearance in healthy adult males, mucociliary clearance was decreased in 32% of the motorcyclists. Additionally, 64% of the motorcyclists had airway acidification and 92% experienced airway symptoms. The median personal NO2 exposure level was 75 mg/m3 for these subjects and a significant association was observed between NO2 and impaired mucociliary clearance (p = 0.036).CONCLUSION:Non-smoking commercial motorcyclists exhibit increased airway symptoms and airway acidification as well as decreased nasal mucociliary clearance, all of which are significantly associated with the amount of exposure to air pollution.

Acids Can Promote the Onset and Multimorbidity of Allergic and Nonallergic Airway Diseases

“…For optimum antimicrobial activity, both in the nose and lungs, ASL pH should be maintained within slightly acidic physiological values (circa pH=6,80) 20, 121, 122 and a lowering can be counterproductive 123 . Interestingly, a decrease of ASL pH after exposure to airborne traffic pollutants has been detected in asthmatic 123 and healthy subjects 124 , albeit to different extents. Historically, endogenous acidification of the airway surfaces has been suggested as a way to measure airway disease 121 .…”

Atmen: Luftschadstoffe und Gesundheit – Teil III

“…2) werden als Ursache für die bei Luftschadstoffbelastung beobachtete eingeschränkte Lungenfunktion neben entzündlichen Reaktionen auch Störungen von Wachstumsprozessen sowie epigenetische Prozesse und strukturelle Veränderungen in der Lungenperipherie diskutiert [131]. Für den Zusammenhang zwischen Luftschadstoffen und Atemwegsinfekten/Bronchitis/ Pneumonie sowie für Exazerbationen bei COPD spielen luftschadstoffinduzierte Schädigungen des Atemwegsepithels sowie eine reduzierte mukoziliäre Clearance eine Rolle, die die Belastung und Empfindlichkeit gegenüber pathogenen Keimen erhöhen [133,134]. Auch entzündliche Reaktionen in den Atemwegen sowie oxidativer Stress verringern sowohl die physikalische Barriere als auch die Immunabwehr gegenüber pathogenen Erregern und erleichtern damit das Überwinden der epithelialen Barriere und die Persistenz von Erregern im Atemtrakt.…”

Mucociliary Clearance: Measures and Therapies

“…To avoid systemic complications, they can be administered via pulsatile irrigation because the steady flow acts via Bernoulli Principle to remove sinus contents and the pulsation fills the vacuumed sinus cavity [20][21][22][23][24][25][26].…”