Recorded presentation

Andrew J. Ghio, MD, Human Studies Division, US Environmental Protection Agency, Campus Box 7315, 104 Mason Farm Road, Chapel Hill, NC 27599, 919-966-0670, ghio.andy@epa.gov

Inhalation of suspended particulate matter (PM) has presented a challenge to the lower respiratory tract in humans for thousands of years. Recently, epidemiologic investigation using the technique of time-series analysis has demonstrated a temporal association between exposures to PM at levels currently observed in cities worldwide and indices of acute human morbidity and mortality. These findings were first met with skepticism but both reevaluation of the initial studies and further investigation providing substantially concordant results confirmed the validity of these observations. Elevated ambient air PM levels have been associated with an increased prevalence of cough, phlegm, and wheeze. Increased hospitalizations for bronchitis and asthma have also been correlated with elevations in ambient air PM. Elevation in ambient air PM levels can be associated with increases in infections. Physiologically, an acute, reversible decrement in pulmonary function has been described following exposure to ambient air pollution particles. Similarly, a permanent loss of pulmonary function has been reported following chronic exposure of children to particles. Particles can also affect measures of bronchial hyperreactivity. Investigation has demonstrated that, relative to the general population, the elderly (defined as either 65 years of age or 75 years of age and over) have an enhanced sensitivity to particulate pollution with increased respiratory morbidity and mortality following exposures. This increased susceptibility of the elderly does not reflect changes in deposition of particles among these individuals. Treatment includes patient education and prevention of heavy exposures.

Learning Objectives:

• This talk will address lung injury following exposures to air pollution particles. Specifically, the increased incidence of respiratory symptoms, elevations in pulmonary infections, decrements in pulmonary function indices, and elevations in airway reactivity will be reviewed. The increased susceptibility of the elderly to respiratory morbidity and mortality will be introduced and mechanisms underlying this offered. Participants will learn about the association between respiratory injury and air pollution particles in the elderly. At the end of this talk, participants will be able to identify the injury, understand proposed mechanisms, and identify interventions to assist the elderly in prevention of excess morbidity and mortality.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation