Biomedical subjects

J Kongerud

Publications and source records attributed to J Kongerud.

At least 19 recordsLinked to original sources

PubMed2006

Genetic and environmental effects on exhaled nitric oxide and airway responsiveness in a population-based sample of twins.

Elevated levels of exhaled nitric oxide (eNO) and airway hyperresponsiveness are intermediate phenotypes of asthma. Using population-based data collected from a sample of twins, the present authors estimated the relative contribution of genes, family environment and nonshared environmental influences to variations in eNO and airway responsiveness (AR). In addition, the genetic and environmental sources of covariation between these two asthma-related phenotypes were investigated. The study population comprised a random sample of 377 adult twins identified through the Norwegian Twin Registry. The main outcome variables were eNO and AR to methacholine. Genetic effects accounted for 60% of the variation in eNO. Family environment accounted for 30% of the variation in AR, while nonshared environmental influences explained the remaining variation for both measures. For both eNO and AR, there were significant regression effects for atopy and smoking. The small, but significant association between eNO and AR was primarily explained by genetic factors. Sub-analyses restricted to atopic and nonsmoking twins strengthened the observation. In conclusion, variations in exhaled nitric oxide and airway responsiveness appear to be explained by different genetic and environmental variance structures. Variation in exhaled nitric oxide is explained by genetic and nonshared environmental effects, whereas an environmental model best explains the variation in airway responsiveness. Common genetic effects explain the small but significant association between exhaled nitric oxide and airway responsiveness.

Adult↗

PubMed2006

Reduced bronchial CD4+ T-cell density in smokers with occupational asthma.

Cigarette smoking may alter bronchial inflammation in asthma. Multicolour immunohistofluorescent examination on bronchial cryosections was used to examine bronchial inflammatory cell infiltrate in patients with occupational asthma. Monoclonal antibodies to CD3, CD4, CD8, T-cell receptor-delta1, CD68 and human leukocyte antigen-DR were combined to identify T-cell subsets and macrophages in bronchial biopsies from 20 workers with occupational asthma (12 smokers and eight nonsmokers), 15 healthy workers (seven smokers and eight nonsmokers) and 10 nonsmoking, nonexposed controls. The increased subepithelial CD4+ T-cell density in nonsmoking asthmatics was not present in smoking asthmatics, who had the lowest CD4+ T-cell density of all groups. The decreased subepithelial CD4+ and CD8+ T-cell density correlated with a reduction in lung function, as measured by percentage predicted forced expiratory volume in one second, in smoking asthmatics only. Although smoking asthmatics had a significantly increased number of intraepithelial CD8+ T-cells and macrophages compared with nonsmoking asthmatics, the proportion of gammadelta-T-cells was significantly decreased in both asthmatic groups. Smoking asthmatics had a distinctly different distribution of T-cell subsets compared with nonsmoking asthmatics. The accumulation of subepithelial CD4+ T-cells, which was observed in nonsmoking asthmatics, appeared to be inhibited in smoking asthmatics, suggesting a smoking-induced bronchial immune modulation, at least in occupational asthma in the aluminium industry.

Air Pollutants, Occupational↗

PubMed2005

The effects of intervention with local electrostatic air cleaners on airborne dust and the health of office employees.

UNLABELLED: The aim of this intervention study was to identify any health improvements in the upper and lower airways of office workers after the installation of local electrostatic air cleaners. Eighty persons with airways symptoms were recruited and randomly assigned to an intervention or control group. Half of the air cleaners had a non-functioning electrostatic unit. Both participants and field researchers were blinded to the group status. Subjective symptoms were recorded using a questionnaire, and indexes calculated for general, irritation and skin symptoms. Objective respiratory health indicators were recorded, with acoustic rhinometry and peak expiratory flow (PEF) meters. In the intervention group there was a decrease in mean dust concentration from 65 to 35 microg/m(3), and a reduction from 57 to 47 microg/m(3) in the control group (P < 0.05 for difference in decline). The reduction was observed for all particles sizes. The irritation and general symptom indices decreased in both groups, but there was no improvement in the intervention group, compared with the control group. Median PEF increased 3 ml/s in the intervention group, and decreased 4 ml/s in the control group. The adjusted odds ratio for an increase above the 70th percentile was 5.7 (95% CI 1.0-32). PRACTICAL IMPLICATIONS: Electrostatic air cleaners can reduce the dust concentration effectively in the office environment. Small, medium and large sized particles can be reduced by approximately 50%, relatively most effectively for the respirable particles. However, the air cleaners tested in this study produced an annoying fan noise. Cleaning efficiency and noise data should be given consideration before installation. This experimental field study suggests that office workers with airways symptoms may benefit from installation of local electrostatic air cleaners.

Adult↗

PubMed2005

Inflammatory markers in bronchoalveolar lavage fluid from human volunteers 2 hours after hydrogen fluoride exposure.

Fluoride has been in focus as a possible causal agent for respiratory symptoms amongst aluminium potroom workers for several decades. Previously, using bronchoalveolar lavage (BAL), we demonstrated airway inflammation in healthy volunteers 24 hours after exposure to hydrogen fluoride (HF). The objective of the present study was to examine early lung responses to HF exposure. Bronchoscopy with BAL was performed 2 hours after the end of 1-hour exposure to HE Significant reductions in the total cell number and the number of neutrophils and lymphocytes were observed in bronchoalveolar portion (BAP), whereas there were no significant changes in the bronchial portion (BP). Significantly decreased concentrations of beta2-MG, IL-6 and total protein were found in both BAP and BP. Additionally, IL-8 was significantly reduced in BP, and ICAM-1 and albumin were present in lower concentrations in BAP. Lung function measurements were not affected by HF exposure. These reported effects are presumably transitory, as many were not present in the airways 24 hours after a similar HF exposure.

Administration, Inhalation↗

PubMed2004

Respiratory symptoms and airflow limitation in asphalt workers.

BACKGROUND: Asphalt workers are exposed to bitumen fume and vapour, and to exhaust from engines and passing traffic. AIMS: To assess the occurrence of respiratory symptoms and signs of airflow limitations in a group of asphalt workers. METHODS: All 64 asphalt workers and a reference group of 195 outdoor construction workers from the same company participated in a cross-sectional study. Spirometric tests and a questionnaire on respiratory symptoms and smoking habits were administered. Respiratory symptoms and lung function were adjusted for age and smoking. RESULTS: The FEV1/FVC% ratio was significantly lower in the asphalt workers than in the referents. Symptoms of eye irritation, chest tightness, shortness of breath on exertion, chest wheezing, physician diagnosed asthma, and chronic obstructive pulmonary disease (COPD) were all significantly more prevalent among the asphalt workers. CONCLUSION: In asphalt workers there is an increased risk of respiratory symptoms, lung function decline, and COPD compared to other construction workers.

Adult↗

PubMed2004

Airway inflammation in aluminium potroom asthma.

AIMS: To examine whether asthma induced by exposure to aluminium potroom emissions (potroom asthma) is associated with inflammatory changes in the airways. METHODS: Bronchial biopsy specimens from 20 asthmatic workers (8 non-smokers and 12 smokers), 15 healthy workers (8 non-smokers and 7 smokers), and 10 non-exposed controls (all non-smokers) were analysed. Immunohistofluorescent staining was performed to identify mucosal total leucocytes (CD45+ leucocytes), neutrophils, and mast cells. RESULTS: Median RBM thickness was significantly increased in both asthmatic workers (8.2 microm) and healthy workers (7.4 microm) compared to non-exposed controls (6.7 microm). Non-smoking asthmatic workers had significantly increased median density of lamina propria CD45+ leucocytes (1519 cells/mm2 v 660 and 887 cells/mm2) and eosinophils (27 cells/mm2 v 10 and 3 cells/mm2) and significantly increased concentrations of exhaled NO (18.1 ppb v 6.5 and 5.1 ppb) compared to non-smoking healthy workers and non-exposed controls. Leucocyte counts and exhaled NO concentrations varied with smoking habits and fewer leucocytes were observed in asthmatic smokers than in non-smokers Asthmatic smokers had significantly increased numbers of eosinophils in lamina propria compared to non-exposed controls (10 v 3 cells/mm2). Both eosinophilic and non-eosinophilic phenotypes of asthma were recognised in the potroom workers and signs of airway inflammation were also observed in healthy workers. CONCLUSIONS: Airway inflammation is a central feature of potroom asthma and exposure to potroom emissions induces pathological alterations similar to those described in other types of asthma. Cigarette smoking seems to affect the underlying mechanisms involved in asthma, as the cellular composition of airway mucosa appears different in asthmatic smokers and non-smokers.

Adult↗

PubMed2004

Lung function 5 yrs after allogeneic bone marrow transplantation conditioned with busulphan and cyclophosphamide.

Long-term data on lung function after bone marrow transplantation (BMT) are inconclusive. Previously, a persistent reduction in gas transfer 1 yr after allogeneic BMT with busulphan and cyclophosphamide conditioning was reported by the current authors. In the present study this reduction was examined to see if it was permanent, transient or progressive. Prospectively, 43 consecutive adult patients with malignant blood disorders undertook lung function measurements prior to BMT, at 3 month intervals during the 1st yr after BMT and finally after 5 yrs. Mean baseline lung function values were >90% predicted. Within the 1st yr after BMT a transient decline in lung volumes and a persistent reduction in gas transfer were observed. After 5 yrs, baseline values were restored for all variables, except in four patients who developed obliterative bronchiolitis. Acute leukaemia and smoking were independently associated with gas transfer reductions at baseline and during the 1st yr after BMT. Allogeneic bone marrow transplantation with busulphan and cyclophosphamide conditioning was associated with a reduction in gas transfer 1 yr after bone marrow transplantation but baseline values were usually restored after 5 yrs. Since recovery may be gradual and slow, an observation period >1 yr is required before drawing conclusions concerning the development of a permanent reduction in lung function after allogeneic bone marrow transplantation conditioned with busulphan and cyclophosphamide.

Adolescent↗

PubMed2003

Risk factors for recent transmission of Mycobacterium tuberculosis.

In recent decades, the decline of tuberculosis has stopped in Western Europe, mainly due to increased immigration from high-prevalence countries. The objective of the current study was to identify risk factors for developing tuberculosis following recent infection, in order to better target interventions. Strains from 861 culture-positive cases, diagnosed in Norway in 1994-1999, were analysed by use of restriction fragment length polymorphism (RFLP). A cluster was defined as two or more isolates with identical RFLP patterns. Risk factors for being part of a cluster were identified by univariate and multivariate analysis. A total of 134 patients were part of a cluster. These constituted 5% Asian-born, 18% Norwegian-born, 24% European-born and 29% African-born patients. Four independent risk factors for being part of a cluster were identified: being born in Norway, being of young age, being infected with an isoniazid-resistant strain and being infected with a multidrug-resistant strain. Transmission of tuberculosis may be further reduced by improving case management, contact tracing, preventive treatment, screening of immigrants and access to health services for the foreign-born population.

Adolescent↗

PubMed2002

Human exposure to hydrogen fluoride induces acute neutrophilic, eicosanoid, and antioxidant changes in nasal lavage fluid.

The development of asthmalike symptoms among aluminum potroom workers has been associated with exposure to fluorides. In the present study, the immediate nasal response in humans was examined subsequent to short-term hydrogen fluoride (HF) exposure. Ten healthy subjects were exposed to HF (3.3-3.9 mg/m(3)) for 1 h. Nasal lavage (NAL) was performed before, immediately after, and 1.5 h after the end of exposure. Control lavages were performed on the same subjects at the same time points but without HF exposure. At the end of HF exposure, 7 of 10 individuals reported upper airway symptoms. A significant increase was observed in the number of neutrophils and total cells, while there was a decrease in cell viability. The changes in neutrophil numbers correlated significantly with the reported airway symptoms. HF also induced a significant increase in tumor necrosis factor-alpha and the total protein content of NAL fluid. Among the eicosanoids, prostaglandin E(2), leukotriene B(4), and peptide leukotrienes were elevated after exposure. Of the antioxidants measured, the concentration of uric acid increased after exposure. In conclusion, exposure to HF induced immediate nasal inflammatory and antioxidant responses in healthy human volunteers. These findings may contribute to a further understanding of the way HF exerts damage to the airways and show that HF could represent an occupational hazard.

Acute Disease↗

PubMed2001

Cumulative exposure to dust causes accelerated decline in lung function in tunnel workers.

OBJECTIVES: To examine whether underground construction workers exposed to tunnelling pollutants over a follow up period of 8 years have an increased risk of decline in lung function and respiratory symptoms compared with reference subjects working outside the tunnel atmosphere, and relate the findings to job groups and cumulative exposure to dust and gases. METHODS: 96 Tunnel workers and a reference group of 249 other heavy construction workers were examined in 1991 and re-examined in 1999. Exposure measurements were carried out to estimate personal cumulative exposure to total dust, respirable dust, alpha-quartz, oil mist, and nitrogen dioxide. The subjects answered a questionnaire on respiratory symptoms and smoking habits, performed spirometry, and had chest radiographs taken. Radiological signs of silicosis were evaluated (International Labour Organisation (ILO) classification). Atopy was determined by a multiple radioallergosorbent test (RAST). RESULTS: The mean exposure to respirable dust and alpha-quartz in tunnel workers varied from 1.2-3.6 mg/m3 (respirable dust) and 0.019-0.044 mg/m3 (alpha-quartz) depending on job task performed. Decrease in forced expiratory volume in 1 second (FEV1) was associated with cumulative exposure to respirable dust (p<0.001) and alpha-quartz (p=0.02). The multiple regression model predicted that in a worker 40 years of age, the annual decrease in FEV1 would be 25 ml in a non-exposed non-smoker, 35 ml in a non-exposed smoker, and 50-63 ml in a non-smoking tunnel worker (depending on job). Compared with the reference group the odds ratio for the occurrence of new respiratory symptoms during the follow up period was increased in the tunnel workers and associated with cumulative exposure to respirable dust. CONCLUSIONS: Cumulative exposures to respirable dust and alpha-quartz are the most important risk factors for airflow limitation in underground heavy construction workers, and cumulative exposure to respirable dust is the most important risk factor for respiratory symptoms. The finding of accelerated decline in lung function in tunnel workers suggests that better control of exposures is needed.

Adult↗

PubMed2001

Gas and dust exposure in underground construction is associated with signs of airway inflammation.

Exposure to gases and dust may induce airway inflammation. It was hypothesized that heavy construction workers who had been exposed to dust and gases in underground construction work for 1 yr, would have early signs of upper and lower airway inflammation, as compared to outdoor workers. A study group comprising 29 nonsmoking underground concrete workers (mean +/- SD age 44+/-12 yrs), and a reference group of 26 outdoor concrete workers (39+/-12 yrs) were examined by acoustic rhinometry, nasal and exhaled nitric oxide spirometry and a questionnaire on respiratory symptoms. Exposure measurements were carried out. The underground workers had higher exposure to total and respirable dust, alpha-quartz and nitrogen dioxide than the references (p<0.001). The occurrence of respiratory symptoms was higher in the underground workers than in the references (p<0.05). Exhaled nitric oxide (NO) (geometric mean+/-SEM) was higher in the underground workers than in the references (8.4+/-1.09 versus 5.6+/-1.07 parts per billion (ppb), p = 0.001), whereas spirometric values were comparable. The underground workers had smaller nasal cross-sectional area and volume than the references, and more pronounced increases after decongestion (p<0.001). To conclude the exposure in underground construction may cause nasal mucosal swelling and increased levels of exhaled nitric oxide, indicating signs of upper and lower airway inflammation.

Airway Obstruction↗

PubMed2000

Increased nitric oxide in exhaled air: an early marker of asthma in non-smoking aluminium potroom workers?

OBJECTIVES: To study exhaled nitric oxide (NO) as a marker of airway inflammation caused by potroom exposure, hypothesising that (a) workers exposed to potroom pollutants would have higher concentrations of NO in expired air than control subjects employed at the same plant but working outside of the potroom atmosphere, and (b) that concentrations of exhaled NO in potroom employees might be positively associated with concentrations of fluoride and exposure to dust. METHODS: A study group comprising 186 male subjects (aged 24-63 years), employed in the potrooms of one Norwegian aluminium smelter, and 40 comparable control subjects (aged 25-60 years) recruited from the same plant, were examined by measurements of exhaled and nasal concentrations of NO, spirometry, and a questionnaire on respiratory symptoms as a part of an annual health surveillance programme. Estimates of exposure to fluorides and dust for selected job categories were obtained by means of personal samplers carried by the workers. RESULTS: In the non-smokers, the concentrations of exhaled NO were higher in the potroom workers than in the controls (median (interquartile range) 9.3 (6.2-15.6) v 5.7 (4.6-8.3) ppb, p=0.001). The two groups did not differ in spirometry and asthma-like symptoms. Non-smoking potroom workers with asthma-like symptoms had higher concentrations of exhaled NO than those with no symptoms (median (interquartile range) 21.0 (19.3-41. 4) v 8.5 (5.9-12.8) ppb, p=0.001), but had comparable spirometric values. In subjects who smoked, the concentrations of exhaled NO did not differ significantly between potroom workers and controls (median (interquartile range) 4.6 (3.3-8.0) v 4.0 (3.4-5.1) ppb. Exhaled NO was not significantly associated with either duration of employment or routine measurements of dust and fluorides. CONCLUSIONS: Exposure to potroom pollutants is associated with increased concentrations of exhaled NO in non-smoking subjects. Nitric oxide in exhaled air may be an early marker of airway inflammation in aluminium potroom workers.

Adult↗

PubMed2000

Increased risk of obstructive pulmonary disease in tunnel workers.

BACKGROUND: Tunnel workers are exposed to gases and particles from blasting and diesel exhausts. The aim of this study was to assess the occurrence of respiratory symptoms and airflow limitation in tunnel workers and to relate these findings to years of exposure. METHODS: Two hundred and twelve tunnel workers and a reference group of 205 other heavy construction workers participated in a cross sectional investigation. Exposure measurements were carried out to demonstrate the difference in exposure between the two occupational groups. Spirometric tests and a questionnaire on respiratory symptoms and smoking habits were applied. Atopy was determined by a multiple radioallergosorbent test (RAST). Radiological signs of silicosis were evaluated. Respiratory symptoms and lung function were studied in relation to years of exposure and adjusted for smoking habits and atopy. RESULTS: Compared with the reference subjects the tunnel workers had a significant decrease in forced vital capacity (FVC) % predicted and forced expiratory volume in one second (FEV(1)) % predicted when related to years of exposure. Adjusted FEV(1) decreased by 17 ml for each year of tunnel work exposure compared with 0.5 ml in outdoor heavy construction workers. The tunnel workers also reported significantly higher occurrence of respiratory symptoms. The prevalence of chronic obstructive pulmonary disease (COPD) was 14% in the tunnel workers compared with 8% in the reference subjects. CONCLUSION: Exposure to dust and gases from diesel exhaust, blasting, drilling and rock transport in tunnel work enhances the risk for accelerated decline in FEV(1), respiratory symptoms, and COPD in tunnel workers compared with other heavy construction workers.

Adult↗

PubMed1999

[Late complications after treatment of Hodgkin's disease].

Treatment of Hodgkin's disease involves chemotherapy and radiation. Both modalities may cause cardiac, pulmonary and thyroid side-effects. In a cross-sectional study, we aimed to assess the occurrence and severity of such complications. From 1980 to 1989, 129 Norwegian patients (< 50 years old) had curative treatment for Hodgkin's disease 116 (90%) of them participated in the study (follow-up period 5-13 years). Methods included lung function tests, chest X-rays, bicycle exercise tests, echocardiography and thyroid function tests. Nearly 30% of the patients reported dyspnoea on exertion and had associated reductions in lung function. Evidence of fibrosis occurred in 68%, but was associated with reduced lung function in only 12%. Pathological left-sided heart valve regurgitations were detected in 24% of the patients, pericardial thickening in 15%, and coronary artery disease in 5%. Biochemical hypothyreosis was found in 67% of the patients. We conclude that cardiac, pulmonary and thyroid dysfunctions are frequent long-term side-effects after treatment for Hodgkin's disease. We recommend annual screening of thyroid function and echocardiographic examination in patients who have received standard mantle field radiotherapy without cardiac shielding. Lung function testing should be done in individuals who require further radiation, chemotherapy or thoracic surgery.

Adult↗

PubMed1999

Increased CD3 positive cells in bronchoalveolar lavage fluid after hydrogen fluoride inhalation.

OBJECTIVES: This study examined whether experimental hydrogen fluoride exposure for 1 hour induces an inflammatory response in the lower respiratory tract that is detectable in bronchoalveolar lavage fluid. METHODS: Nineteen healthy, nonsmoking men were exposed for 1 hour to constant low (<0.6 mg/m3), intermediate (0.7-2.4 mg/m3), or high (2.5-5.2 mg/m3) concentrations of hydrogen fluoride. Bronchoalveolar lavage was performed at least 3 weeks before and 24 hours after the exposure. For 15 subjects differential countings were performed. RESULTS: There was a significant increase in the percentage of CD3 positive cells in the bronchial portion for those exposed to "intermediate" and "high" concentrations. For the "high" exposure group the increase in the bronchoalveolar portion was also significant. A significant correlation was found between the increase in the percentage of lymphocytes and CD3 positive cells in the bronchoalveolar portion (Spearman's coefficient r=0.68, P=0.008). Myeloperoxidase and interleukin-6 increased significantly in the bronchial portion for those exposed to "high" concentrations. There was a significant increase in myeloperoxidase (P=0.005) for all the exposures, while there was a decrease in E-selectin (P=0.007). CONCLUSIONS: Hydrogen fluoride may induce an inflammatory reaction in the airways at concentrations that can occur in the ambient air in the primary aluminum industry.

Adult↗

PubMed1998

Exposure to nitrogen dioxide and the occurrence of bronchial obstruction in children below 2 years.

BACKGROUND: The objective of the investigation was to test the hypothesis that exposure to nitrogen dioxide (NO2) has a causal influence on the occurrence of bronchial obstruction in children below 2 years of age. METHODS: A nested case-control study with 153 one-to-one matched pairs was conducted within a cohort of 3754 children born in Oslo in 1992/93. Cases were children who developed > or = 2 episodes of bronchial obstruction or one episode lasting >4 weeks. Controls were matched for date of birth. Exposure measurements were performed in the same 14-day period within matched pairs. The NO2 exposure was measured with personal samplers carried close to each child and by stationary samplers outdoors and indoors. RESULTS: Few children (4.6%) were exposed to levels of NO2 > or = 30 microg/m3 (average concentration during a 14-day period). In the 153 matched pairs, the mean level of NO2 was 15.65 microg/m3 (+/-0.60, SE) among cases and 15.37 (+/-0.54) among controls (paired t = 0.38, P = 0.71). CONCLUSIONS: The results suggest that NO2 exposure at levels observed in this study has no detectable effect on the risk of developing bronchial obstruction in children below 2 years of age.

Air Pollution, Indoor↗

PubMed1997

A test chamber for experimental hydrogen fluoride exposure in humans.

An inhalation chamber was built to perform experimental studies with hydrogen fluoride (HF), other gases, and particulate matter. The present study sought to describe a new gas delivery system and the distribution and concentration of HF gas in the chamber. The aluminum chamber has a volume of 19.2 m3 and a variable ventilation rate of about 1 to 10 air changes per hour. The negative pressure difference between the chamber and outside air can be regulated from 0 to 300 Pa. HF was fed at concentrations of up to 4000 mg/m3 directly into the ventilation duct feeding the chamber through openings with diameters as small as 50 microns, oriented opposite to the airflow. Gas flow was varied from about 0.1 dm3/min at a pressure of 4 atm. The dilution factor of HF concentration from cylinder to chamber was on the order of 10(3) to 10(4). The standard deviation (SD) of the HF concentrations at a fixed measurement point during a 1-hour test was typically 0.05 mg/m3 at a time-weighted average (TWA) concentration of 2.66 mg/m3. The SD of the TWA HF concentrations at six locations in the chamber was typically 0.05 mg/m3 and 0.29 mg/m3 at 0.61 and 3.46 mg/m3, respectively. Human exposure could be predicted from calculations based on ventilation data, gas flow, and observed ratio between calculated and measured concentrations. When the target exposure concentration was 1.5 mg/m3, the measured mean exposure concentration was typically 1.54 mg/m3 (range: 1.4-1.7 mg/m3, SD 0.09 mg/m3, n = 8). The chamber is well-suited for inhalation studies in humans. Chamber atmosphere was controlled and has proved to be stable and homogeneous, even in tests with HF, a highly reactive gas in the class of superacids.

Air Pollutants↗

PubMed1997

The role of passive smoking in the development of bronchial obstruction during the first 2 years of life.

We assessed the effect of exposure to environmental tobacco smoke on the risk of developing bronchial obstruction in a 2-year cohort study of 3,754 children born in Oslo, Norway, during a period of 15 months in 1992-1993. We collected questionnaire information on the child's health and environmental exposures at birth and when the child was age 6 months (follow up rate = 95%), 12 months (92%), 18 months (92%), and 24 months (81%). The outcome of interest was defined as two or more episodes of bronchial obstruction or one obstruction lasting more than 1 month, and it was verified by a specialist group evaluating data from questionnaires, clinical examinations, and health records. The risk of bronchial obstruction was increased in children exposed to environmental tobacco smoke (cumulative incidence = 0.109) compared with unexposed children (0.071), with an adjusted odds ratio of 1.6 [95% confidence interval (CI) = 1.3-2.1]. The effect was seen for maternal smoking alone (odds ratio = 1.6; 95% CI = 1.0-2.6), paternal smoking alone (odds ratio = 1.5; 95% CI = 1.1-2.2), and both parents smoking (odds ratio = 1.5; 95% CI = 1.0-2.2). There was no clear exposure-response pattern. The findings indicate that exposure to environmental tobacco smoke such as is experienced in Norwegian housing increases the risk of developing bronchial obstruction during the first 2 years of life.

Asthma↗