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Featured Application: The present study found a significant relationship between the prevalence of skin symptom exacerbations and the concentration of particulate matter 2.5 and its ionic components. A few studies have evaluated this topic, so the present study may be an important stepping stone for future research. (1) Background: To date, little research has epidemiologically examined whether the concentration of particulate matter (PM) 2.5 and its ionic components is related to the prevalence of skin symptom exacerbations. Therefore, this study aimed to clarify this association in patients with allergic diseases. (2) Methods: From 1 February to 31 May 2020, we evaluated the daily prevalence of skin symptoms in outpatients with allergic diseases being treated at Fukuoka National Hospital, Fukuoka, Japan, and measured the concentration of PM2.5 and its ionic components. (3) Results: Univariate analysis showed a statistically significant association between skin symptoms and the concentration of PM2.5 and the ionic components SO42−, NH4+, K+, and Mg2+; multivariate analysis showed a statistically significant association between the daily prevalence of skin symptom and the concentration of the ionic components SO42− or Mg2+. (4) Conclusions: Our findings indicate that the concentration of some PM2.5 ionic components may affect skin symptom in patients with allergic diseases. [ABSTRACT FROM AUTHOR]

Itching due to atopic dermatitis causes sleep disorders in children, but its pathology is unknown. The aim of this study is to investigate nocturnal scratching as an indirect index of itching during sleep and its relationship with depth of sleep in children with atopic dermatitis. Nocturnal scratching was measured in a total of 20 children with atopic dermatitis, using a smartwatch installed with the application Itch Tracker. Depth of sleep was analysed using polysomnography. The severity of atopic dermatitis was scored using Eczema Area and Severity Index (EASI) and Patient-Oriented Eczema Measure (POEM). The number and time of nocturnal scratching measured by Itch Tracker had a significantly positive correlation with EASI scores, whereas POEM scores were not correlated with EASI scores. Mean sleep efficiency was 90.0% and scratching episodes (n=67) started mainly during the awake stage or light sleep stages. In the scratching episodes that started during sleep stages (n=34), the sleep stage changed to a lighter one or to the awake stage in 35.5% of episodes. Itch Tracker is applicable to measure nocturnal scratching in children. Nocturnal scratching can deteriorate quality of sleep by changing the sleep stage to a lighter one or to the awake stage. [ABSTRACT FROM AUTHOR]

The relationship between exposure to polycyclic aromatic hydrocarbons and nasal symptoms currently remains unclear. Therefore, we herein examine this relationship in 51 adults living in Ishikawa prefecture, Japan, and conducted a 2 month follow-up survey on these participants. All participants were asked to record daily nasal symptoms in an allergy diary during the study period between 1 April to 31 May 2020. We collected air pollutant samples during the study period and determined the concentrations of PAHs and total suspended particulates by high-performance liquid chromatography. Sulfur dioxide and nitrogen dioxide concentrations were obtained through the Atmospheric Environmental Regional Observation System. We used generalized estimating equations to analyze the association between pollutant and nasal symptoms. After adjustment for confounding factors, the B values of fluoranthene, pyrene, and Benzo[k]fluoranthene were 2.389 (p = 0.026), 3.744 (p = 0.022) and 9.604 (p = 0.041), respectively, with a one-day lag. In contrast, the B value of indeno[1,2,3-cd]pyrene was −6.664 (p = 0.013) with no lag. Collectively, these results suggest ambient PAHs such as Flt, Pyr, and BkF were associated with nasal symptoms in adults. Further studies are needed to elucidate the mechanisms contributing to the relationships between specific PAHs and nasal symptoms. [ABSTRACT FROM AUTHOR]

Ambient polycyclic aromatic hydrocarbons' (PAHs) specific components are likely involved in respiratory disease development and exacerbation in children and adults. Airborne PAH exposure's effects on cough symptoms in children and adults with chronic coughs in Kanazawa and Fukuoka, Japan, were investigated in this longitudinal study. A total of 98 patients with chronic coughs were enrolled and followed up between 1 April and 31 May 2020. The enrolled patients were non-smoking adults and children aged 3–83 years. Cough diaries were used to record and collect daily cough symptoms. High-performance liquid chromatography coupled with a fluorescence detector was used to determine the particulate PAH content in daily total suspended particles collected on quartz fiber filters. Ambient concentrations of fine particulate matter, nitrogen dioxide, and sulfur dioxide were obtained from local monitoring sites. Generalized estimated equations were used to estimate the association between daily PAHs and cough symptoms. Among nine PAHs measured, benz[a]anthracene (BaA) was significantly associated with cough symptoms for both lag4 and lag5 PAH exposure. These findings suggest that airborne specific PAHs, especially BaA, affect cough symptoms in children and adults with chronic cough. Further studies are needed to develop effective measures to prevent respiratory diseases against specific PAHs. [ABSTRACT FROM AUTHOR]

Focusing on the components of fine particulate matter, i.e., PM2.5, we have analyzed the factors that led to the high concentrations of each chemical component in PM2.5 during our observations in Fukuoka, Japan in spring 2020. The backward trajectory showed that air masses reached Fukuoka via the Yellow Sea and the southern part of South Korea when PM2.5 and each chemical component were high in concentrations. On the other hand, diurnal variations in ozone were also observed, suggesting that both transboundary and local air pollution are involved. Air masses reached the southern part of the Kyushu region when only sulfate concentrations were high. A volcano eruption led the high sulfate concentration. When only polycyclic aromatic hydrocarbons (PAHs) concentrations were high, air masses often reached the northern part of Kyushu, indicating that there may be a specific local source for PAHs. [ABSTRACT FROM AUTHOR]

Featured Application: Few studies have examined the efficacy of masks in preventing the effects of ionic components of air pollution on health. The results of this study should serve as a base for future research. Mask wearing can protect health care workers. However, its efficacy in avoiding the health effects of air pollution is not well studied. Recently, we evaluated the relationship between air pollution and health status or peak expiratory flow rate (PEFR). At the beginning of that study, about 20% of people were wearing masks. However, in the same period one year later, most people were wearing masks because of the COVID-19 pandemic. Therefore, in this study, we examined the relationship between mask wearing, concentration of ionic components of PM2.5, respiratory symptoms, and PEFR. Seventy-two patients in Fukuoka City with asthma and allergic diseases measured PEFR daily and recorded respiratory symptoms and mask wearing in a diary. We measured the ionic components of PM2.5 in Fukuoka City and examined the relationships between patient measurements, mask wearing, and air pollution. Univariate analysis showed that, in 2020, but not in 2021, some ionic components of PM2.5, i.e., Cl−, NO3−, Na+, and Mg2+, were significantly correlated with the frequency of cough and nasal symptoms and a decrease in PEFR. Some ionic components of PM2.5 may increase the frequency of respiratory symptoms and decrease PEFR in patients with allergic diseases; however, this tendency is not seen when masks are used. The use of masks may be one of the factors that attenuate the effects of PM2.5 ionic components. [ABSTRACT FROM AUTHOR]

Featured Application: Few studies have evaluated the relationship between the concentration of ionic components in PM2.5 and clinical symptoms or peak expiratory flow rate. The present study is an important stepping stone for future research. (1) Background: Few studies have evaluated the association between the ionic components of PM2.5 and respiratory symptoms or peak expiratory flow rate (PEFR). The aim of this study was to clarify these associations. (2) Methods: Patients with allergic diseases treated at Fukuoka Hospital recorded their morning and evening PEFR and respiratory symptoms in a diary. We measured PM2.5 and its ionic components in Fukuoka City and examined the relationship with PEFR and respiratory symptoms by univariate and multivariate analysis. (3) Results: Among the ionic components of PM2.5, Cl−, NO3−, Na+, K+, and Mg2+ were significantly correlated with the frequency of coughing and nasal symptoms. In univariate analysis, the concentrations of each of the above ions was significantly associated with a decrease in PEFR and the concentrations of each was associated with at least one respiratory symptom or PEFR. Multivariate analysis of items significantly correlated with PEFR indicated that the concentration of ionic components may predict changes in PEFR. (4) Conclusions: In patients with allergic diseases, some ionic components of PM2.5 may increase the frequency of respiratory symptoms and decrease PEFR, so further study and caution are required in daily clinical practice. [ABSTRACT FROM AUTHOR]

Background: Childhood asthma is a major risk for low lung function in later adulthood, but what factors in asthma are associated with the poor lung function during childhood is not known. Objective: To identify clinical factors in children with asthma associated with low or declining lung function during the treatment. Methods: We enrolled children with asthma who had been treated throughout three age periods, i.e., 6–9, 10–12, and 13–15 years old, at seven specialized hospitals in Japan. Clinical information and lung function measurements were retrieved from the electronic chart systems. To characterize the lung function trajectories during each age period, we evaluated the forced expiratory volume 1 (FEV1) with % predicted values and individual changes by the slope (S) from linear regression. We defined four trajectory patterns: normal (Group N) and low (Group L), showing %FEV1 ≥80% or <80% throughout all three periods; upward (Group U) and downward (Group D), showing S ≥ 0 or S < 0%. Logistic regression analysis was performed to compare factors associated with the unfavorable (D/L) versus favorable (N/U) groups. Results: Among 273 eligible patients, 197 (72%) were classified into Group N (n = 150)/U (n = 47), while 76 (28%) were in Group D (n = 66)/L (n = 10). A history of poor asthma control, long-acting beta2 agonist use, and a lower height Z-score during 13–15 years were associated with an unfavorable outcome (Group D/L). Conversely, inhaled corticosteroid (ICS) use during 10–12 years and high-dose ICS use during 13–15 years were associated with a favorable outcome (Group N/U). Conclusion: We identified several factors that are associated with unfavorable lung function changes in pediatric asthma. Attention should be paid to the possible relationship between yearly changes in lung function and poor asthma control, use of ICS (and its dose) and use of LABA. [ABSTRACT FROM AUTHOR]

To clarify different effects of Asian dust (AD), long-range transported from Asian continent, on total suspended particles (TSP) and polycyclic aromatic hydrocarbons (PAHs) in Japan, TSP were simultaneously collected during AD periods (from 1 March to 31 May 2020 and 2021) in Fukuoka and Kanazawa. During AD days, decided by Light Detection and Ranging and Japan Meteorological Agency, TSP concentrations increased significantly (p < 0.001) at two sampling sites. PAH concentrations increased in Kanazawa (p < 0.001) but not in Fukuoka on AD days. Correlation coefficients (r) between daily TSP and total PAHs concentrations were weak in Kanazawa: 0.521 (non-AD) and 0.526 (AD) (p < 0.01), and in Fukuoka: 0.321 (non-AD) and 0.059 (AD). However, correlation between seasonal (average monthly) TSP and total PAH concentrations were stronger: 0.680 (Kanazawa) and 0.751 (Fukuoka). The reasons might be that seasonal variations of TSP and total PAHs in two cities depend equally on planetary scale westerly, while daily TSP and total PAHs variations in each city varied by different transportation distances from AD and PAHs sources in the Asian continent to Japan. Different local sources and meteorological conditions were considered. These results are important for elucidating the causes of chronic and acute respiratory diseases. [ABSTRACT FROM AUTHOR]

Rationale: Epidemiological evidence indicates that ambient exposure to particulate matter ⩽2.5 μm in aerodynamic diameter (PM2.5) has adverse effects on lung function growth in children, but it is not actually clear whether exposure to low-level PM2.5 results in long-term decrements in lung function growth in pre- to early-adolescent schoolchildren. Objectives: To examine long-term effects of PM2.5 within the 4-year average concentration range of 10-19 μg/m3 on lung function growth with repeated measurements of lung function tests. Methods: Longitudinal analysis of 6,233 lung function measurements in 1,466 participants aged 8-12 years from 16 school communities in 10 cities around Japan, covering a broad area of the country to represent concentration ranges of PM2.5, was done with a multilevel linear regression model. Forced expiratory volume in 1 second, forced vital capacity (FVC), and maximal expiratory flow at 50% of FVC were used as lung function indicators to examine the effects of 10-μg/m3 increases in the PM2.5 concentration on relative growth per each 10-cm increase in height. Results: The overall annual mean PM2.5 level was 13.5 μg/m3 (range, 10.4-19.0 μg/m3). We found no association between any of the lung function growth indicators and increases in PM2.5 levels in children of either sex, even after controlling for potential confounders. Analysis with two-pollutant models with O3 or NO2 did not change the null results. Conclusions: This nationwide longitudinal study suggests that concurrent, long-term exposure to PM2.5 at concentrations ranging from 10.4 to 19.0 μg/m3 has little effect on lung function growth in preadolescent boys or pre- to early-adolescent girls. [ABSTRACT FROM AUTHOR]

The relationship between exercise-induced bronchoconstriction (EIB) and exertional dyspnea in children and adolescents is yet to be fully established. This study examined whether indicators of fractional exhaled nitric oxide (FeNO), forced expiratory volume in 1 s (FEV1) percent predicted at baseline, and dyspnea are useful for predicting children and adolescents with EIB. We enrolled 184 children and adolescents diagnosed with asthma (mean age 11.2 years); participants were divided into two groups according to age (12 years) and were subjected to a 6-min exercise challenge test. Lung function tests and modified Borg scale scores were used to examine perceptions of dyspnea at 0, 5 and 15 min after exercise. Among children, the maximum percentage drop in FEV1 after exercise correlated significantly with FeNO (adjusted β = 2.3, P < 0.001) and with the perception of dyspnea at 5 min after exercise (adjusted β = 1.9, P < 0.001). Among adolescents, the maximum percentage drop in FEV1 correlated with FeNO (adjusted β = 2.7, P = 0.007) and with lung function (FEV1, percent predicted; adjusted β = −0.28, P = 0.006). Children with EIB had significantly stronger dyspnea after exercise than did children without EIB. Adolescents even without EIB may experience more exertional dyspnea than children without EIB. Overall, our findings indicated that EIB was associated with FeNO and exertional dyspnea in asthmatic children. By contrast, EIB was associated with FEV1 percent predicted at baseline and FeNO but not with exertional dyspnea in asthmatic adolescents. [ABSTRACT FROM AUTHOR]

Abstract Objective To examine relationships between a mother's stress-related conditions and parenting attitudes and their children's asthmatic status. Methods 274 mothers of an asthmatic child 2 to 12 years old completed a questionnaire including questions about their chronic stress/coping behaviors (the "Stress Inventory"), parenting attitudes (the "Ta-ken Diagnostic Test for Parent-Child Relationship, Parent Form"), and their children's disease status. One year later, a follow-up questionnaire was mailed to the mothers that included questions on the child's disease status. Results 223 mothers (81%) responded to the follow-up survey. After controlling for non-psychosocial factors including disease severity at baseline, multiple linear regression analysis followed by multiple logistic regression analysis found chronic irritation/anger and emotional suppression to be aggravating factors for children aged < 7 years; for children aged 7 and over, the mothers' egocentric behavior was a mitigating factor while interference was an aggravating factor. Conclusions Different types of parental stress/coping behaviors and parenting styles may differently predict their children's asthmatic status, and such associations may change as children grow.