Published online November 1, 2007
PEDIATRICS Vol. 120 Supplement November 2007, pp. S114 (doi:10.1542/peds.2007-0846U)
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ALLERGY


Carbon in Airway Macrophages and Lung Function in Children

Bradley E. Chipps, MD

Sacramento, CA

ABSTRACT

Kulkarni N, Pierse N, Rushton L, Grigg J. N Engl J Med. 2006;355:21–30

PURPOSE OF THE STUDY. To define the extent of pulmonary-function abnormalities that may be attributed to exposures to particulate matter with a median aerodynamic diameter of <10 µm (PM10) as a result of fossil fuel combustion.

STUDY POPULATION. The study included 114 children (aged 8 to 15 years) without any chronic respiratory condition who were living in the same residence for 1 year. All children had a forced expiratory volume in 1 second (FEV1) of >80% predicted.

METHODS. Pulmonary-function testing and induced sputum were obtained on the same day. PM10 values from all sources were collected for 1 year. The results were controlled for passive tobacco-smoke exposure.

RESULTS. A total of 62 (56%) of the 114 subjects were able to produce sputum. An increase of 1 µg/m3 in PM10 was associated with an increase of 0.10 µm2 in the carbon content of airway macrophages. Each 1.0 µm2 increase in carbon content was associated with a significant decrease in pulmonary function (decrease of 17% in FEV1, 12.9% in forced vital capacity, and 34.7% in forced expiratory flow, midexpiratory phase).

CONCLUSIONS. A significant reduction in pulmonary function resulted from increased exposure to products of fossil fuel combustion.

REVIEWER COMMENTS. The reduction in pulmonary function in this cohort of children who did not have current lower airway symptoms is in the same order of magnitude as patients with moderate persistent asthma, which underscores the need for less toxic energy sources.