REPOST: Healthier lungs in California kids after pollution controls

A study conducted in California found better lung function among kids as the state's air quality improved.  This Reuters article provides the details.

(Reuters Health) - Doctors have long predicted that less air pollution will produce healthier lungs. Now a first-of-its-kind study of 2,120 children in southern California has documented dramatically better lung function growth as air quality has improved.

       

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Over a 13-year period, the proportion of children with poor lung capacity and lung health fell by half as levels of nitrogen dioxide and particulate matter dropped. The gains were seen both in youngsters who had asthma and in those who did not.

“It certainly supports the efforts that have been made over 40 years to improve air quality,” chief author Dr. James Gauderman of the Department of Preventive Medicine at the University of Southern California in Los Angeles told Reuters Health. “We would expect improvements in other urban centers to produce similar improvements in children’s health.”

The study, published in the New England Journal of Medicine, complements research showing that childhood lung function deteriorates and the risk of asthma rises as pollution levels rise.

"This is an association study, so there's always a question of cause and effect. Maybe these people got healthier on their own, ate better diets. You can never say it's an absolute proof," said Dr. Norman H. Edelman, senior consultant for scientific affairs at the American Lung Association.

        

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"But it's not a standalone study. It's based on older studies that show an association between the degree of air pollution and lung function in kids. This turns around and looks at improvement," he told Reuters Health.

Gauderman and his colleagues examined the long-term effects in children by studying three groups during three time periods between 1994 and 2011. Typically, the children entered the study around age 11 and were followed for four years, a period when the lungs are developing rapidly. All lived in the Los Angeles area, a region of the U.S. known for air pollution problems, which have been abating as a result of strict state controls.

“We looked at the proportion of children whose lung function was below 80 percent of normal. That’s a cutoff a physician will often use to flag a person for a possible issue with their lungs,” Gauderman said. While 7.9 percent of children fell into that category in 1998, the proportion had dropped to 3.6 percent by 2011.

“We certainly suspected that improving air quality would improve children’s health,” Gauderman said. “We were surprised by the magnitude of the effect that we’ve seen.”

"What's news about this is the large magnitude of the effect, from 8 percent down to 4 percent," said Edelman, who was not connected to research. "Asthma is present in 10 percent of the population and that's a major health problem. If a percentage of those kids is going to have worse asthma because the air pollution has limited their lung growth, that's a big deal."

During the study years, the air improved “dramatically,” Gauderman’s team writes in their report. For example, in 1994-1997, each cubic meter of air in one of the most-polluted communities, Mira Loma, had 31.5 micrograms of small particles called PM2.5 that penetrate deep into the lungs. By 2007-2010, Mira Loma averaged 17.8 micrograms of PM2.5 per cubic meter of air, a 43 percent decline. All five study sites had significant drops in particle pollution and nitrogen dioxide, they note.

Overall, average lung capacity increased by 91.4 milliliters for every decrease of 14.1 parts per billion in nitrogen dioxide. It rose by 65.5 ml for each decrease of 8.7 micrograms per cubic meter of particle pollution. Significant changes were not linked to ozone levels, but levels of that pollutant have not declined as dramatically over time.

       

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“There were significant effects on lung-function growth in both boys and girls, although the magnitude of the air-pollution effect was significantly larger in boys than in girls,” the researchers conclude.

“We found no significant association between growth in height and change in pollution during the study period, which indicates that our findings on lung-function growth are probably not the result of a secular trend in general development,” they write.

California has stricter pollution controls than the U.S. as a whole, but Edelman said even the federal clean air act has cleaned up a lot of pollution "and this study is part of that. We're making progress. There's still a long way to go. We still have much more unacceptable effects of air pollution than we should have."

Dr. Lisa Marie Cannon is a board certified physician who specializes in pulmonary care.  Visit this Facebook page for more access to resources on related topics. 

REPOST: E-Cigarettes May Not Help Smokers Quit Tobacco, Study Finds

Do e-cigarettes really help smokers stop the habit? Discover the truth from this Philly.com article below.

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While some proponents of "vaping" claim that smokers who try e-cigarettes may use them as a bridge to quitting smoking, a new study finds that the opposite may true.

The study, published April 16 in the American Journal of Public Health, found that smokers who used e-cigarettes were less likely to quit regular cigarettes than those who hadn't tried the devices.

A team led by Dr. Wael Al-Delaimy, chief of the division of global public health at the University of California, San Diego School of Medicine, followed 1,000 California smokers for one year.

The researchers found that smokers who said they had ever used e-cigarettes were about half as likely to cut down on their smoking and 59 percent less likely to quit, compared to those who never used e-cigarettes.

"Based on the idea that smokers use e-cigarettes to quit smoking, we hypothesized that smokers who used these products would be more successful in quitting," Al-Delaimy said. "But the research revealed the contrary."

Two anti-smoking experts said the study casts doubt on the notion of e-cigarettes as a smoking-cessation aid.

"These results confirm the potential harm e-cigarettes cause smokers, in that they may not only result in continued smoking but they may also discourage or delay quit attempts," said Patricia Folan, director of the Center for Tobacco Control at the North Shore-LIJ Health System in Great Neck, N.Y.

She believes that "the knowledge gap about electronic cigarettes is currently being filled in large part by e-cigarette industry advertising rather than scientific information."

But one industry representative took issue with the new study.

"Asking smokers about their 'ever use' of a product, and then somehow attributing that 'ever use' to their subsequent success or failure to quit smoking months or years down the line, is dishonest and unethical," said Gregory Conley, president of the American Vaping Association.

He said that to keep "credibility," the researchers should "have also sought out data about the relationship between 'ever use' of nicotine replacement therapy products like the gum and patch and a smoker's ability to quit."

Dr. Harlan Weinberg is medical director of pulmonary and critical care medicine at Northern Westchester Hospital in Mount Kisco, N.Y. He believes that more research on the issue is needed.

"There are no currently accepted guidelines for the use of e-cigarettes regarding smoking-cessation efficacy or as a cessation tool," he pointed out. "Their rapid use among the general population and as a social phenomenon require a more thorough evaluation regarding their safety and effectiveness."

Study author Al-Delaimy concurred. "We need further studies to answer why [smokers using e-cigarettes] cannot quit," he said. "One hypothesis is that smokers are receiving an increase in nicotine dose by using e-cigarettes."

Over the past two years a number of leading medical groups, including the American Heart Association, the American Cancer Society, the American Society of Clinical Oncology and the American Medical Association, have called for increased regulation of the sale and advertising of e-cigarettes, citing health concerns.

Dr. Lisa Marie Cannon is a licensed physician specializing in pulmonary care. Discover more information on internal medicine and pulmonary health from this Facebook page.