DIFFERENTIAL SUSCEPTIBILITY TO INHALED POLLUTANTS - EFFECTS OF DEMOGRAPHICS AND DISEASES

Inhaled pollutants and respiratory disease deserve particular attentio n at a conference focused on susceptibility and environmental risk. In haled air contains diverse biological, physical and chemical stressors which may cause upper and lower respiratory inflammation and exacerba te complex polygenic disorders such as asthma and sinusitis. This pape r focuses on intrinsic susceptibility factors of demographics and dise ases as well as genetic background. The National Health Information Su rvey shows that acute and chronic respiratory conditions are common at all ages, but their incidence and prevalence vary between age groups. Susceptibility is therefore not a fixed characteristic, but the aggre gate effect of changing intrinsic factors such as age and disease. Whi le ethnicity is often cited as a risk factor for disease prevalence or severity, recent research shows that measurable factors such as nasal ellipticity determine exposure-dose relationships, while the imperfec t surrogate of ethnicity does not. Studies also show that exposure-dos e relationships can be modified by recent exposures, and additional in formation is clearly needed in this area. We propose that evidence for the genetic contribution to pollutant susceptibility be sought in int er-individual variation in responses of homogenous, well characterized individuals to short term controlled pollutant exposure. Future impro vements in risk assessment models will be based on a precise identific ation of factors that determine exposure-dose relationships, and a mec hanistic understanding of the reasons that a demographic factor or dis ease appears to confer altered susceptibility. (C) 1997 Elsevier Scien ce B.V.