American Thoracic Society Journal news tips for July (first issue)

July 03, 2002

Lung function growth rates of children affected by air pollution

Researchers provided further evidence that ambient levels of air pollution produced significant effects on children's lung function growth rates. Between 1996 and 2000, investigators studied a cohort of 1,678 southern California children, enrolled as fourth graders. They found that significant deficits in lung function growth rates were associated with exposure to acid vapor, nitric dioxide, particulate matter, and elemental carbon. The average annual growth rate for astandard lung function test in the children was reduced by 10 percent. The researchers also reported that larger deficits were seen in children who reported spending more time outdoors. Of all the pollutants studied, acid vapor showed the most consistent effect on lung function growth for the cohort. The air pollution data came from monitoring stations in the 12 study communities; pollution levels were monitored continuously. The investigators said that further follow-up of participants, all of whom were members of the Children's Health Study-a 10-year investigation of children's respiratory health in 12 southern California communities, would allow determination of whether pollution-related deficits in lung function growth persist into adulthood. The research appears in the first issue for July 2002 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.

Asthma at age 5 not associated with antibiotic use in first year

Despite the publication of five prior retrospective studies showing an association between antibiotic use in early life and asthma in childhood, investigators in the first prospective study of the finding found no association between antibiotic use in the first year of life and subsequent development of asthma, allergic rhinitis, or eczema at age 5. The investigators studied 498 infants who were born to parents who had a history of allergy or asthma. Although 352 (over 70 percent) of the infant participants received 752 courses of oral antibiotics in the first year of life, the investigators, who monitored them for five years, found no significant association between oral antibiotic use and recurrent wheezing, asthma, allergic rhinitis, or eczema at age 5. Previous retrospective studies in England, New Zealand, Belgium, and German children came to the opposite conclusion. The investigators felt that prior retrospective results could have been due to recall bias associated with children who actually had asthma in their first year of life. Fifty youngsters dropped out of the current study before the fifth year was completed. Of the 448 participants remaining, 90 (slightly over 20 percent) had at least one atopic disease (asthma, allergic rhinitis, or eczema) at age 5. (Atopy is an allergy to which one has an inherited tendency.) About one-third of these children received no antibiotics in the first year of life. The investigators said that their study was not designed to be a random sample because they had selected a stable population from a group with a parental history of asthma and allergy. Moreover, they believed their findings were relevant to a group at high risk for the development of asthma. The research appears in the first issue for July 2002 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.

Photographic recognition helps locate TB transmission sites

Recognition by TB patients of photographs of other patients with TB, when combined with restriction fragment length polymorphism (RFLP) analysis of specimens to determine disease clustering, can enhance TB control by showing epidemiologic links between these persons, according to a study of 159 subjects in Tarrant County Texas. Of these patients, 76 (48 percent) were linked in 19 clusters. (When studied with RFLP, patients who had specimens (isolates) that were identical or closely related were considered to be part of a cluster.) The researchers said that their findings provided the first evidence that a combination of RFLP analysis and photographic recognition by patients of others in their TB cluster could facilitate the identification of sites where tuberculosis transmission can take place. They found four homeless shelters and five bars that were frequented significantly more often by patients infected with specific TB strains. In Tarrant County, there are approximately 1,963 bars. In the final analysis, one homeless shelter and one bar were shown to be independent predictors of clustering, suggesting that they were sites of TB transmission. The research was published in the first issue for July 2002 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.
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American Thoracic Society

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