Association of temperature and absolute humidity with incidence of exercise-induced bronchoconstriction in children

Anna P. Tikkakoski; Markus Reini; Kalle Sipilä; Juho E. Kivistö; Jussi Karjalainen; Mika Kähönen; Antti Tikkakoski; Lauri Lehtimäki

doi:10.1111/apa.17295

Association of temperature and absolute humidity with incidence of exercise-induced bronchoconstriction in children

Anna P. Tikkakoski, Markus Reini, Kalle Sipilä, Juho E. Kivistö, Jussi Karjalainen, Mika Kähönen, Antti Tikkakoski, Lauri Lehtimäki

Research output: Contribution to journal › Article › Scientific › peer-review

Abstract

Aim: Exercise test outdoors is widely used to diagnose asthma in children, but it is unclear how much outdoor air factors affect the results. Methods: We analysed 321 outdoor exercise challenge tests with spirometry in children 6–16 years conducted due to suspicion of asthma or for assessing the effect of medication on asthma. We studied the association of FEV₁ decrease and incidence of exercise-induced bronchoconstriction (EIB) with temperature, relative humidity (RH) and absolute humidity (AH). Results: Asthma was diagnosed in 57% of the subjects. AH ≥5 g/m³, but not RH or temperature, was associated with the EIB incidence (p = 0.035). In multivariable logistic regression, AH ≥5 g/m³ was negatively associated (OR = 0.51, 95% CI [0.28─0.92], p = 0.026) while obstruction before exercise (OR = 2.11, 95% CI [1.16─3.86], p = 0.015) and IgE-mediated sensitisation were positively associated with EIB (OR = 2.24, 95% CI [1.11─4.51], p = 0.025). AH (r = −0.12, p = 0.028) and temperature (r = −0.13, p = 0.023) correlated with decrease in FEV₁. In multivariable linear regression, only AH was associated with FEV₁ decrease (coefficient = −0.044, 95% CI [−0.085 to −0.004], p = 0.033). Conclusion: AH of outdoor air associates with occurrence and severity of EIB in outdoor exercise tests in children. Care should be taken when interpreting negative outdoor exercise test results if AH of air is high.

Original language	English
Pages (from-to)	1942-1948
Journal	Acta Paediatrica
Volume	113
Issue number	8
Early online date	2024
DOIs	https://doi.org/10.1111/apa.17295
Publication status	Published - Aug 2024
Publication type	A1 Journal article-refereed

Funding

The study was supported by grants from the Research Foundation of the Pulmonary Diseases, Ida Montin's Foundation, the Tampere Tuberculosis Foundation, Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital and the Foundation of the Finnish Anti\u2010Tuberculosis Association. None of the authors have any conflict of interest related to this study. This study was funded by grants from the Research Foundation of the Pulmonary Diseases, Ida Montin's Foundation, the Tampere Tuberculosis Foundation, Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital and the Foundation of the Finnish Anti\u2010Tuberculosis Association.

Funders	Funder number
Tampereen tuberkuloosisäätiö
Ida Montinin Säätiö
Foundation of the Finnish Anti-Tuberculosis Association

Keywords

air humidity
asthma
exercise test
exercise-induced asthma
pulmonary function tests

Publication forum classification

Publication forum level 1

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Pediatrics, Perinatology, and Child Health
Physiology (medical)

Access to Document

10.1111/apa.17295

https://urn.fi/URN:NBN:fi:tuni-202407317829Licence: Unspecified

Embargoed Document

Tikkakoski et al spirometry AH temperature and EIB 2024_04_21-1
Accepted author manuscript, 440 KB
Licence: Unspecified
Embargo ends: 23/05/25

Cite this

@article{546c92a8a8ae4c6ea1c213f2ad6d1449,

title = "Association of temperature and absolute humidity with incidence of exercise-induced bronchoconstriction in children",

abstract = "Aim: Exercise test outdoors is widely used to diagnose asthma in children, but it is unclear how much outdoor air factors affect the results. Methods: We analysed 321 outdoor exercise challenge tests with spirometry in children 6–16 years conducted due to suspicion of asthma or for assessing the effect of medication on asthma. We studied the association of FEV1 decrease and incidence of exercise-induced bronchoconstriction (EIB) with temperature, relative humidity (RH) and absolute humidity (AH). Results: Asthma was diagnosed in 57% of the subjects. AH ≥5 g/m3, but not RH or temperature, was associated with the EIB incidence (p = 0.035). In multivariable logistic regression, AH ≥5 g/m3 was negatively associated (OR = 0.51, 95% CI [0.28─0.92], p = 0.026) while obstruction before exercise (OR = 2.11, 95% CI [1.16─3.86], p = 0.015) and IgE-mediated sensitisation were positively associated with EIB (OR = 2.24, 95% CI [1.11─4.51], p = 0.025). AH (r = −0.12, p = 0.028) and temperature (r = −0.13, p = 0.023) correlated with decrease in FEV1. In multivariable linear regression, only AH was associated with FEV1 decrease (coefficient = −0.044, 95% CI [−0.085 to −0.004], p = 0.033). Conclusion: AH of outdoor air associates with occurrence and severity of EIB in outdoor exercise tests in children. Care should be taken when interpreting negative outdoor exercise test results if AH of air is high.",

keywords = "air humidity, asthma, exercise test, exercise-induced asthma, pulmonary function tests",

author = "Tikkakoski, {Anna P.} and Markus Reini and Kalle Sipil{\"a} and Kivist{\"o}, {Juho E.} and Jussi Karjalainen and Mika K{\"a}h{\"o}nen and Antti Tikkakoski and Lauri Lehtim{\"a}ki",

note = "Publisher Copyright: {\textcopyright} 2024 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.",

year = "2024",

month = aug,

doi = "10.1111/apa.17295",

language = "English",

volume = "113",

pages = "1942--1948",

journal = "Acta Paediatrica",

issn = "0803-5253",

publisher = "Wiley",

number = "8",

}

TY - JOUR

T1 - Association of temperature and absolute humidity with incidence of exercise-induced bronchoconstriction in children

AU - Tikkakoski, Anna P.

AU - Reini, Markus

AU - Sipilä, Kalle

AU - Kivistö, Juho E.

AU - Karjalainen, Jussi

AU - Kähönen, Mika

AU - Tikkakoski, Antti

AU - Lehtimäki, Lauri

PY - 2024/8

Y1 - 2024/8

N2 - Aim: Exercise test outdoors is widely used to diagnose asthma in children, but it is unclear how much outdoor air factors affect the results. Methods: We analysed 321 outdoor exercise challenge tests with spirometry in children 6–16 years conducted due to suspicion of asthma or for assessing the effect of medication on asthma. We studied the association of FEV1 decrease and incidence of exercise-induced bronchoconstriction (EIB) with temperature, relative humidity (RH) and absolute humidity (AH). Results: Asthma was diagnosed in 57% of the subjects. AH ≥5 g/m3, but not RH or temperature, was associated with the EIB incidence (p = 0.035). In multivariable logistic regression, AH ≥5 g/m3 was negatively associated (OR = 0.51, 95% CI [0.28─0.92], p = 0.026) while obstruction before exercise (OR = 2.11, 95% CI [1.16─3.86], p = 0.015) and IgE-mediated sensitisation were positively associated with EIB (OR = 2.24, 95% CI [1.11─4.51], p = 0.025). AH (r = −0.12, p = 0.028) and temperature (r = −0.13, p = 0.023) correlated with decrease in FEV1. In multivariable linear regression, only AH was associated with FEV1 decrease (coefficient = −0.044, 95% CI [−0.085 to −0.004], p = 0.033). Conclusion: AH of outdoor air associates with occurrence and severity of EIB in outdoor exercise tests in children. Care should be taken when interpreting negative outdoor exercise test results if AH of air is high.

AB - Aim: Exercise test outdoors is widely used to diagnose asthma in children, but it is unclear how much outdoor air factors affect the results. Methods: We analysed 321 outdoor exercise challenge tests with spirometry in children 6–16 years conducted due to suspicion of asthma or for assessing the effect of medication on asthma. We studied the association of FEV1 decrease and incidence of exercise-induced bronchoconstriction (EIB) with temperature, relative humidity (RH) and absolute humidity (AH). Results: Asthma was diagnosed in 57% of the subjects. AH ≥5 g/m3, but not RH or temperature, was associated with the EIB incidence (p = 0.035). In multivariable logistic regression, AH ≥5 g/m3 was negatively associated (OR = 0.51, 95% CI [0.28─0.92], p = 0.026) while obstruction before exercise (OR = 2.11, 95% CI [1.16─3.86], p = 0.015) and IgE-mediated sensitisation were positively associated with EIB (OR = 2.24, 95% CI [1.11─4.51], p = 0.025). AH (r = −0.12, p = 0.028) and temperature (r = −0.13, p = 0.023) correlated with decrease in FEV1. In multivariable linear regression, only AH was associated with FEV1 decrease (coefficient = −0.044, 95% CI [−0.085 to −0.004], p = 0.033). Conclusion: AH of outdoor air associates with occurrence and severity of EIB in outdoor exercise tests in children. Care should be taken when interpreting negative outdoor exercise test results if AH of air is high.

KW - air humidity

KW - asthma

KW - exercise test

KW - exercise-induced asthma

KW - pulmonary function tests

U2 - 10.1111/apa.17295

DO - 10.1111/apa.17295

M3 - Article

AN - SCOPUS:85193984882

SN - 0803-5253

VL - 113

SP - 1942

EP - 1948

JO - Acta Paediatrica

JF - Acta Paediatrica

IS - 8

ER -

Association of temperature and absolute humidity with incidence of exercise-induced bronchoconstriction in children

Abstract

Funding

Keywords

Publication forum classification

ASJC Scopus subject areas

Access to Document

Embargoed Document

Fingerprint

Cite this