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'Diesel fumes make asthma worse'

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NT looks behind the headlines on a recent story into respiratory health.

What did the media say?

The newspapers reported that diesel fumes from heavy traffic make it harder for people with asthma to breathe.

What did the research show?

The stories were based on research into air quality in London’s Oxford Street by Imperial College London.

Researchers recruited 60 adults with mild or moderate asthma. Each subject walked up and down Oxford Street for two hours and, on a separate occasion, through Hyde Park.

The authors found that walking on Oxford Street induced asymptomatic, but consistent, reductions in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) that were significantly larger than the reductions in FEV1 and FVC after exposure in Hyde Park.

These changes were accompanied by increases in biomarkers of neutrophilic inflammation and airway acidification, the authors found. The changes were associated most consistently with exposures to ultrafine particles and elemental carbon.

What did the researchers say?

Study author Fan Chung, professor from the National Heart and Lung Institute at Imperial College London, said: ‘For the first time we are able to measure exactly what’s happening inside the lungs of people with asthma when they spend only a couple of hours strolling in a real-life polluted area.

‘By observing the effect of pollutant diesel particles on the lung surfaces, we can confirm that such an exposure causes inflammation in the lungs of asthmatic people.

‘Our study should not necessarily deter asthmatic people from venturing into Oxford Street, but different measures to reduce the levels of pollution, and to protect the lungs of asthmatic people from the effects of pollution, should be considered.’

What does this mean for nursing practice?

Leanne Male, assistant director of research at Asthma UK, said: ‘We know that living near a busy road is linked to worsening of asthma symptoms and there is a wealth of anecdotal evidence showing that people with asthma believe that traffic fumes have an adverse affect on their condition, with nearly half telling us that it discourages them from walking in congested areas.

‘We do not yet know enough, however, about the specific chemicals in exhaust fumes responsible for triggering these symptoms and hope that further research like this will provide the answers to help us improve the lives of the millions of people with asthma in the UK who are affected by traffic fumes every day.’

New England Journal of Medicine (2007) 357: 2348-2358

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