August 2009

Notes from the Section

• The Summer issue of the SECTION BULLETIN is online now, with a column on why you should attend this year's AARC Congress in San Antonio and a great article on new applications for cardiopulmonary testing.
• Nominations for our 2009 Specialty Practitioner of the Year will be wrapping up Aug. 31; nominations may be made online via our NOMINATIONS FORM .
• Keep a watch. The advance program for the AARC INTERNATIONAL RESPIRATORY CONGRESS will be online soon, but you can register right now for best rates. Plenty of good programming in the area of diagnostics will be offered. Keep the date -- San Antonio, Dec. 5-8.

Spirometry Centile Charts for Young Children
A British project to collate lung function data from healthy children between the ages of 3-7 has produced reference data for this population. The Asthma UK centiles charts for spirometry are based on measurements from 3,777 Caucasian children from 15 centers in 11 countries. According to the researchers, they provide “a continuous reference with a smooth transition into adolescence and adulthood” and “improve existing pediatric equations by considering the between-subject variability to define a more appropriate age-dependent lower limit of normal.” A variety of equipment, measurement protocols, and population characteristics were used in the project. The investigators published their findings in the July 2 Epub edition of the American Journal of Respiratory and Critical Care Medicine. READ ABSTRACT

Popcorn Lung: A New Study
The general media has reported widely on the link between reduced lung function and butter flavorings containing diacetyl used in microwave popcorn. Now researchers from the University of Cincinnati have quantified the risk. They conducted spirometry on 765 microwave popcorn production plant workers in 2005 and 2006, finding:

• Inclusion in the high-exposure group (mixers) prior to respirator use was associated with a significantly decreased FEV1 percent predicted in non-Asian and Asian males and an eight-fold increased risk for airway obstruction; cumulative diacetyl exposure caused similar results.
• No significant impact was seen on nonmixers or between current diacetyl exposure and persistent decline in FEV1.
• Unprotected exposure as a mixer to butter flavoring including diacetyl resulted in decrements in FEV1 percent predicted and increased airway obstruction.

The authors conclude, “Control of employee exposure to butter flavoring additives is warranted in regard to both short-term peak and 8-h workday exposure.” The investigation appears in this month's European Respiratory Journal. READ ABSTRACT

FeNO and the Indoor Environment
A new study out of Canada finds the type of heating system in children's homes is associated with the fractional concentration of exhaled nitric oxide (FeNO). However, environmental tobacco smoke and mold are not, despite previous reports linking them to FeNO as well. The results come from a cross-sectional study of 1,135 children with and without asthma and/or allergies. Specifically, electric baseboard heating was associated with a significant increase in FeNO in healthy and allergic children alike when compared with forced air and hot water radiant heat. The study also linked pet dogs, but not cats, with significantly lower FeNO in both healthy and allergic children. The research appeared in the May-June issue of the Canadian Respiratory Journal. READ ABSTRACT

Menstrual Cycle Affects Lung Function in Asthmatic Women
Is worsening airflow obstruction in asthmatic women associated with changes in gas transfer and the pulmonary vascular bed during the menstrual cycle? That's the question Cleveland Clinic researchers set out to answer in a new study involving 13 asthmatic women and 10 healthy controls. All were evaluated over the menstrual cycle with spirometry, gas transfer, nitric oxide, hemoglobin, factors affecting hemoglobin binding affinity, and pro-angiogenic factors. Results showed:

• Airflow and lung diffusing capacity (DLCO) varied over the menstrual cycle, with peak levels during menses that subsequently declined to nadir in the early luteal phase.
• In contrast to healthy women, changes in DLCO were associated with changes in membrane diffusing capacity; DLCO was not related to pro-angiogenic factors.
• DLCO was not different between the two groups, though methemoglobin and carboxyhemoglobin were higher in asthmatics than healthy women.

The investigators believe these findings suggest, “Asthmatic women experience cyclic changes in airflow as well as gas transfer and membrane diffusing capacity supportive of a hormonal effect on lung function.” The study was published in the June 11 Epub edition of the American Journal of Respiratory and Critical Care Medicine. READ ABSTRACT