Reduced Exercise Tolerance and Pulmonary Capillary Recruitment with Remote Secondhand Smoke ExposureReportar como inadecuado




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Rationale

Flight attendants who worked on commercial aircraft before the smoking ban in flights pre-ban FAs were exposed to high levels of secondhand smoke SHS. We previously showed never-smoking pre-ban FAs to have reduced diffusing capacity Dco at rest.

Methods

To determine whether pre-ban FAs increase their Dco and pulmonary blood flow during exercise, we administered a symptom-limited supine-posture progressively increasing cycle exercise test to determine the maximum work watts and oxygen uptake achieved by FAs. After 30 min rest, we then measured Dco and at 20, 40, 60, and 80 percent of maximum observed work.

Results

The FAs with abnormal resting Dco achieved a lower level of maximum predicted work and compared to those with normal resting Dco mean±SEM; 88.7±2.9 vs. 102.5±3.1%predicted ; p = 0.001. Exercise limitation was associated with the FAs- FEV1 r = 0.33; p = 0.003. The Dco increased less with exercise in those with abnormal resting Dco mean±SEM: 1.36±0.16 vs. 1.90±0.16 ml-min-mmHg per 20% increase in predicted watts; p = 0.020, and amongst all FAs, the increase with exercise seemed to be incrementally lower in those with lower resting Dco. Exercise-induced increase in was not different in the two groups. However, the FAs with abnormal resting Dco had less augmentation of their Dco with increase in during exercise mean±SEM: 0.93±0.06 vs. 1.47±0.09 ml-min-mmHg per L-min; p<0.0001. The Dco during exercise was inversely associated with years of exposure to SHS in those FAs with ≥10 years of pre-ban experience r = −0.32; p = 0.032.

Conclusions

This cohort of never-smoking FAs with SHS exposure showed exercise limitation based on their resting Dco. Those with lower resting Dco had reduced pulmonary capillary recruitment. Exposure to SHS in the aircraft cabin seemed to be a predictor for lower Dco during exercise.



Autor: Mehrdad Arjomandi , Thaddeus Haight, Nasrat Sadeghi, Rita Redberg, Warren M. Gold

Fuente: http://plos.srce.hr/



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