ACUTE RESPIRATORY RESPONSE TO PROLONGED, MODERATE LEVELS OF SIDESTREAM TOBACCO-SMOKE

Environmental tobacco smoke (ETS) is a significant component of indoor air pollution yet the acute upper respiratory response has no: been w ell studied. The goal of this study was to determine the response of h ealthy subjects to moderate levels of sidestream tobacco smoke (SS). T wenty-three subjects were challenged on 2 separate days to clean air o r SS (2 h, 15 ppm carbon monoxide, at rest). Subjects completed sympto m questionnaires, posterior rhinomanometry, and body plethysmography. Average total and differential cell counts and albumin concentration w ere determined on nasal lavage samples. The urinary cotinine:creatinin e ratio was used as a biomarker of exposure. Following SS exposure, ir ritant and rhinitis symptoms increased, nasal resistance rose from 4.9 +/- 0.4 to 6.3 +/- 0.6 cm H2O/L/s and specific airway conductance dec reased from 0.14 +/- 0.01 to 0.13 +/- 0.01 cm H2O-1 s(-1). Total cell counts, neutrophils, and albumin were unchanged. An increased nasal co ngestive response did not correlate with an increased cotinine:creatin ine ratio. A history of ETS rhinitis did not predict an increased grou p response to smoke, but individuals with the largest physiologic and inflammatory response were historically ETS sensitive. In summary, hea lthy normal subjects demonstrate nasal congestion with exposure to mod erate levels of SS without evidence of increased nasal vascular permea bility.