Nitrogen dioxide exposure from domestic gas cooking and airway response in asthmatic women
T P Nga, C S R Seeta, W C Tanb, S C Fooc
a Department of
Community, Occupational and Family Medicine, Faculty of Medicine,
National University of Singapore, Lower Kent Ridge Road, Singapore, b Respiratory
Medicine Department, National University Hospital, Singapore, c Department of Chemical Engineering,
National University of Singapore
Correspondence to: Dr T P Ng cofngtp{at}nus.edu.sg
Received 12 April 2000; Returned to authors 5 June 2000; Revised version received 9 April 2001; Accepted for publication 25 April 2001
BACKGROUND
Previous
studies have not found a consistent association between exposure to
domestic cooking using gas appliances and exacerbation of asthma. We
investigated the immediate airflow response to acute exposure from
single episodes of gas cooking, and peak airflow variability from
continued exposure to repeated episodes of gas cooking in a group of
non-smoking asthmatic women.
METHODSSixteen adult
non-smoking women with mild to severe persistent asthma were studied.
The acute short term level of nitrogen dioxide (NO2) during
gas cooking episodes and the mean exposure to NO2 from
repeated gas cooking episodes were measured over a 2 week period, as
well as proxy measures of frequency of cooking on each day and the
length of time spent cooking each day. Their asthma status was
monitored using peak expiratory flow rates (PEFR) before and after
cooking, 2 week self-recorded serial readings of PEFR, respiratory
symptom severity score, and use of rescue bronchodilators for acute
asthma attacks.
RESULTSCooking was
significantly associated with an immediate mean fall in PEFR of 3.4%
(p=0.015, paired t test). The acute short term NO2 level during cooking was significantly correlated
with the fall in PEFR (r=-0.579; p=0.019).
The frequency of cooking over a 2 week period was positively correlated
with the mean exposure to NO2
(r=0.529; p=0.042). Continued exposure to
NO2 over a 2 week period was associated significantly with
increased frequency of rescue bronchodilator usage for asthma attacks
(r=0.597; p=0.031). However, it was
negatively associated with PEFR variability
(r=-0.512; p=0.051) and respiratory symptom
severity score (r= -0.567; p=0.043), probably due to the masking effects of bronchodilator treatment.
CONCLUSIONSAcute
short term exposure to NO2 from single episodes of gas
cooking is associated with immediate airflow limitation. Continued exposure from repeated episodes of gas cooking in asthmatic women is
associated with greater use of rescue bronchodilators.
Keywords: nitrogen dioxide; gas cooking; asthma
© 2001 by Thorax
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