ผลของหมอกควันต่อความแข็งแรงของกล้ามเนื้อหายใจและความเสี่ยงการเกิดโรคปอดอุดกั้นเรื้อรังในคนสุขภาพดี: หมอกควันต่อแรงดันสูงสุดของการหายใจและความเสี่ยงต่อการเกิดโรคปอดอุดกั้นเรื้อรัง

Arunrat Srithawong; Puttipong Poncumhak; Patchareeya Amput; Kewalee Seeharach; Sirintip Kumfu; Patcharin Phrompao; Maitip Sittitan; Tichanon Promsrisuk

Authors

Arunrat Srithawong Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Thailand
Puttipong Poncumhak Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Thailand
Patchareeya Amput Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Thailand
Kewalee Seeharach Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Thailand
Sirintip Kumfu Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Thialand
Patcharin Phrompao Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Thailand
Maitip Sittitan Physical Therapy Unit, Maechan hospital, Thailand
Tichanon Promsrisuk Division of Physiology, School of Medical Sciences, University of Phayao, Thailand

Keywords:

Smog, respiratory muscle strength, maximum respiratory pressure, peak expiratory flow rate

Abstract

Objective Smog impacts the risk of respiratory disease. However, the effects of smog on the healthy people have not been intensively investigated. Therefore, this study aimed to evaluate the influences of smog on maximal respiratory pressure, peak expiratory flow rate (PEFR) and risk of chronic obstructive pulmonary disease (COPD) in healthy people.

Methods A total of 400 voluntary healthy subjects, aged between 30-87 years old were recruited. All participants have been inhabited in Phayao province for at least 3 years. The maximum respiratory pressure was determined by using respiratory pressure meter (MicroRPM^®). The PEFR was assessed by using Mini Wright peak flow meter and the questionnaire was used for analysis the risk of COPD.

Results The results showed that there was no difference of PEFR level in the volunteers who had been long term exposed to smog compared with standard value, with the p=0.694. However, the maximum inspiratory pressure and maximum expiratory pressure of the participants were significantly reduced to 22.46±17.10 and 17.93±35.17 cm H₂O, respectively, with the p <0.001. Moreover, 4.5 percent of the healthy volunteers have risk to be COPD.

Conclusion Smog caused decreasing of maximum inspiratory pressure and maximum expiratory pressure and the people who have been long term exposed to smog have a high risk to be COPD.

References

Pollution Control Department [Internet]. Smoke pollution in Northern areas: Problems and suggestions (in Thai). 2011. [Cited 2018 Aug 10]. Available from: https://www.pcd.go.th/info_serv/air_thaihaze.html.

Rungchotvevit J. Why smoke and dust impact the all the world, Pollution of the world (in Thai). Green Research. 2010;16:12-5.

Phayao Provincial Public Health Office. Situation report and solving smog problems in medical and public health in Phayao province (in Thai). 2017 [Cited 2019 Feb 26]. Available from: https://www.pyomoph.go.th/backoffice/files/1039.pdf.

Moeltner K, Kim MK, Zhu E, Yang W. Wildfire smoke and health impacts: A closer look at fire attributes and their marginal effects. J Environ Econ Manag. 2013;66:476-96.

Sutherland ER, Make BJ, Vedal S, Zhang L, Dutton SJ, Murphy JR, et al. Wildfire smoke and respiratory symptoms in patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol. 2005;115:420-2.

Laowakul W. Toxins from burning in the open air. Green Research. 2013;23:1-4.

Swiston JR, Davidson W, Attridge S, Li GT, Brauer M, van Eeden SF. Wood smoke exposure induces a pulmonary and systemic inflammatory response in firefighters. Eur Respir J. 2008;32:129-38.

Backes CH, Nelin T, Gorr MW, Wold LE. Early life exposure to air pollution: how bad is it? Toxicol Lett. 2013;216:47-53.

Alman BL, Pfister G, Hao H, Stowell J, Hu X, Liu Y, et al. The association of wildfire smoke with respiratory and cardiovascular emergency department visits in Colorado in 2012: a case crossover study. Environ Health. 2016;15:64.

MacNee W, Donaldson K. Mechanism of lung injury caused by PM10 and ultrafine particles with special reference to COPD. Eur Respir J Suppl. 2003;40:47-51.

Padkao T, Suwapong P, Zatow M, Na Nongkhai S. Impacts of wildfires smoke on peak expiratory fl ow rate and risk of COPD in healthy people (in Thai). In: University of Phayao, Proceeding of the 1st Phayao Research Conference; 2012.

Padkao T, Amput P, Kluayhomthong S, Jones C. Impacts of wildfire smog on lung volume and pulmonary function in healthy people (in Thai). In: University of Phayao, Proceeding of the 2nd Phayao Research Conference; 2013. p. 30.

Nitamangkoon S. Research statistics. Bangkok: Kasetsart university press; 2005.

Bryant A, Cerfolio RJ. Differences in epidemiology, histology, and survival between cigarette smokers and never-smokers who develop non-small cell lung cancer. Chest. 2007;132:185-92.

Khalil M, Wagih K, Mahmoud O. Evaluation of maximum inspiratory and expiratory pressure in patients with chronic obstructive pulmonary disease. J Chest Dis Tuberc. 2014;63:329-35.

Mongkol S, Teethaisong Y, Korngkit J, Inaugson N. The comparisons of respiratory muscle strength and six-minute walk distance between female obesity class I and normal-weight. J Med Tech Phy Ther. 2013;25:289-96.

Freitas FS, Ibiapina CC, Alvim CG, Britto RR, Parreira VF. Relationship between cough strength and functional level in elderly. Rev Bras Fisioter. 2010;14:470-6.

Jalayondeja W, Verner O, Jarungjitaree S, Tscheikuna J. Respiratory muscle strength explained by age and weight in female and male. J Med Assoc Thai. 2014;97:16-20.

Dejsomritrutai W, Nana A, Maranetra KN, Chuaychoo B, Maneechotesuwan K, Wongsurakiat P, et al. Reference spirometric values for healthy lifetime nonsmokers in Thailand. J Med Assoc Thai. 2000;83:457-66.

Marino E, Caruso M, Campagna D, Polosa R. Impact of air quality on lung health: myth or reality? Ther Adv Chronic Dis. 2015;6:286-98.

Abelsohn A, Stieb DM. Health effects of outdoor air pollution: approach to counseling patients using the Air Quality Health Index. Can Fam Physician. 2011;57:881-7.

Liu JC, Wilson A, Mickley LJ, Dominici F, Ebisu K, Wang Y, et al. Wildfire-specific fine particulate matter and risk of hospital admissions in urban and rural counties. Epidemiology. 2017;28:77-85.

Tantisuwat A, Thaveeratitham P. Effects of smoking on chest expansion, lung function, and respiratory muscle strength of youths. J Phys Ther Sci. 2014;26:167-70.

Tabaku A, Bejtja G, Bala S, Toci E, Resuli J. Effects of air pollution on children’s pulmonary health. Atmos Environ. 2011;45:7540-5.

Rice MB, Ljungman PL, Wilker EH, Gold DR, Schwartz JD, Koutrakis P, et al. Short-term exposure to air pollution and lung function in the Framingham Heart Study. Am J Respir Crit Care Med. 2013;188:1351-7.

Pothirat C, Chaiwong W, Liwsrisakun C, Bumroongkit C, Deesomchok A, Theerakittikul T, et al. Influence of particulate matter during seasonal smog on quality of life and lung function in patients with chronic obstructive pulmonary disease. Int J Environ Res Public Health. 2019;16:106.