Analysing the causes of chronic cough: relation to diesel exhaust, ozone, nitrogen oxides, sulphur oxides and other environmental factors

Abstract

Air pollution remains a leading cause of many respiratory diseases including chronic cough. Although episodes of incidental, dramatic air pollution are relatively rare, current levels of exposure of pollutants in industrialized and developing countries such as total articles, diesel exhaust particles and common cigarette smoke may be responsible for the development of chronic cough both in children and adults. The present study analyses the effects of common environmental factors as potential causes of chronic cough. Different PubMed-based researches were performed that related the term cough to various environmental factors. There is some evidence that chronic inhalation of diesel can lead to the development of cough. For long-term exposure to nitrogen dioxide (NO2), children were found to exhibit increased incidences of chronic cough and decreased lung function parameters. Although a number of studies did not show that outdoor pollution directly causes the development of asthma, they have demonstrated that high levels pollutants and their interaction with sunlight produce ozone (O3) and that repeated exposure to it can lead to chronic cough. In summary, next to the well-known air pollutants which also include particulate matter and sulphur dioxide, a number of other indoor and outdoor pollutants have been demonstrated to cause chronic cough and therefore, environmental factors have to be taken into account as potential initiators of both adult and pediatric chronic cough.

Longitudinal study of respiratory function and symptoms in a non-smoking group of long-term officially-acknowledged victims of pollution-related illness

“…We consider that the respiratory disease in this group was caused mainly by the high environmental levels of SO 2 and NO 2 during 1965 to 1974, because approximately 60% of the victims were first registered during the 1970s. Our results are consistent with those of past reports indicating that high environmental levels of SO 2 (40–60 ppb) and NO 2 (17.4 ppb) can affect the bronchi and bronchioles, resulting in respiratory symptoms such as a cough, sputum, wheeze, and breathlessness [1-7,15-17]. Our results show significant differences in respiratory function between males and females at the time of certification, with FEV 1 % predicted, FVC % predicted, VC % predicted, and FEV 1 /FVC (%) significantly lower in males than in females.…”

“…Epidemiological studies have reported that air pollution is associated with adverse respiratory effects [1-7] and increased mortality [8-10]. Some areas of Japan experienced high levels of air pollution during the period of rapid economic growth after World War II and many people who lived in these areas complained about respiratory symptoms.…”

Associations of Cough Prevalence with Ambient Polycyclic Aromatic Hydrocarbons, Nitrogen and Sulphur Dioxide: A Longitudinal Study

“…Exposure to environmental irritants, including ambient pollutants known to trigger cough both in children and adults, has been reviewed [8,9,10]. In addition, there is evidence from cross-sectional studies that have shown the association in adults [11,12].…”

Expression, Localisation and Functional Implications of the Transporter Protein PEPT2 in the Upper Respiratory Tract

“…Infections of the pharynx and upper respiratory tract are common conditions that may initiate exacerbations of bronchial asthma [1], chronic obstructive pulmonary disease (COPD) [1, 2] or occupational and environmental airway diseases [3,4,5,6,7]. Especially in patients with moderate to severe stages, such as GINA stage 3–4 for bronchial asthma or GOLD stage 3–4 for COPD, these infections can cause severe damages to the respiratory tract and may lead to hospital admission [8].…”