Chest
Volume 103, Issue 2, February 1993, Pages 353-358
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Effects of a Bronchoprovocation Challenge Test With Cigarette Sidestream Smoke on Sensitive and Healthy Adults

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In order to study the acute effects of environmental tobacco smoke on lung function, a cigarette sidestream smoke provocation test (analogous to a nonspecific bronchial provocation test) was performed. Ten persons with airways hyperreactive to methacholine and ten normoreactive persons were tested. A dose-response relationship was found for symptoms. The lung function of the normoreactive persons was not altered by short-time inhalation of sidestream smoke. The hyperreactive subjects, however, experienced significant decreases in FEV1, FVC, and MEF50. The decrease was most pronounced after the lowest dose of 2 ppm smoke-induced CO, leading to a mean (all of 6.3 percent in FEV1. Five of ten subjects with hyperreactive airways showed a decrease in FEV1 of more than 10 percent during the sidestream smoke provocation, one of them a decrease of over 20 percent after inhalation of 16 ppm CO sidestream smoke. We conclude that even short exposure to low concentrations of cigarette sidestream smoke causes significant impairment of lung function in sensitive persons.

Section snippets

Subjects

Two groups of individuals were tested: ten persons with hyperreactive airways and ten healthy individuals, matched for age and sex. In the text, tables, and figures, odd numbers are attributed to the hyperreactive persons and even numbers are attributed to the healthy persons. All participants were nonsmokers verified by carboxyhemoglobin measurements (mean and SD: 1.5 percent, 0.47).

We selected 12 subjects out of patient histories of the Allergy Clinic of the Zurich (Switzerland) University

Subjective Symptoms

The short-time inhalation, even of high concentrations of sidestream smoke, was well tolerated by both groups. Symptoms were in the mean weak even at the highest concentrations. Three of the ten hyperreactive persons and four of the ten healthy persons never indicated any symptoms. Subject 19 had impressive cough attacks after 8 and 16 ppm CO sidestream smoke.

A symptoms score was plotted with the number of subjects indicating a specific symptom multiplied by the indicated intensity (a little =

DISCUSSION

Several studies have investigated the effect of passive smoking on lung function of asthmatic patients.7, 8, 9, 10, 11, 12, 13 The definition of asthma and origin of asthma varies. In our study, sensitive persons were characterized by airways hyperreactive to methacholine. We exposed two groups (hyperreactive and normal) to cigarette sidestream smoke. A threshold limit value to acute ETS exposure (1.5 to 2.0 ppm CO) of healthy persons was proposed by Muramatsu et al,1 based on eye irritation

CONCLUSIONS

The lung function of persons with airways normoreactive to methacholine is not significantly altered by short-time inhalations of increasing concentrations of cigarette sidestream smoke. Even a 2-min exposure to a low concentration of sidestream smoke causes significant impairment of lung function of persons with hyperreactive airways. The initial decline in lung function parameters suggests an irritant type of response, but almost all slopes with increasing exposure are negative. Nonspecific

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    This study was supported by a grant from the Forschungsrat für Rauchen und Gesundheit.

    Manuscript revision accepted June 12.

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