BACKGROUND: Exposure to cold weather increases blood pressure (BP) and may aggravate the symptoms and influence the prognosis of subjects with a diagnosis of hypertension. We tested the hypothesis that subjects with hypertension alone or in combination with another cardiovascular disease (CVD) experience cold-related cardiorespiratory symptoms more commonly than persons without hypertension. This information is relevant for proper treatment and could serve as an indicator for predicting wintertime morbidity and mortality.
METHODS: A self-administered questionnaire inquiring of cold-related symptoms was obtained from 6591 men and women aged 25-74 yrs of the FINRISK Study 2002 population. BP was measured in association with clinical examinations. Symptom prevalence was compared between subjects with diagnosed hypertensive disease with (n = 395) or without (n = 764) another CVD, untreated diagnosed hypertension (n = 1308), measured high BP (n = 1070) and a reference group (n = 2728) with normal BP.
RESULTS: Hypertension in combination with another CVD was associated with increased cold-related dyspnoea (men: adjusted odds ratio 3.94, 95% confidence interval 2.57-6.02)/women: 4.41, 2.84-6.86), cough (2.64, 1.62-4.32/4.26, 2.60-6.99), wheezing (2.51, 1.42-4.43/;3.73, 2.08-6.69), mucus excretion (1.90, 1.24-2.91/2.53, 1.54-4.16), chest pain (22.5, 9.81-51.7/17.7, 8.37-37.5) and arrhythmias (43.4, 8.91-211/8.99, 3.99-20.2), compared with the reference group. Both diagnosed treated hypertension and untreated hypertension and measured high BP resulted in increased cardiorespiratory symptoms during the cold season.
CONCLUSION: Hypertension alone and together with another CVD is strongly associated with cold-related cardiorespiratory symptoms. As these symptoms may predict adverse health events, hypertensive patients need customized care and advice on how to cope with cold weather.
Early-life respiratory tract infections (RTIs) and dental caries are among the most common infectious diseases worldwide. The relations between early RTIs and development of caries in permanent teeth have not been studied earlier. We assessed childhood RTIs as potential predictors of caries in young adulthood in a 20-year prospective population-based cohort study (The Espoo Cohort Study). Information on lower respiratory tract infections (LRTIs) that had required hospitalization was retrieved from the National Hospital Discharge Registry (n = 1623). Additional information on LRTIs and upper RTIs (URTIs) was assessed based on the questionnaire reports that covered the preceding 12 months. Caries was measured as the number of teeth with fillings (i.e. filled teeth, FT) reported in the 20-year follow-up questionnaire. The absolute and relative excess numbers of FT were estimated applying negative binomial regression. The mean number of FT in young adulthood was 1.4 greater among subjects who had experienced LRTIs requiring hospitalization before the age of 2 years (SD 4.8) compared to those without any such infections (SD 3.4), and the adjusted relative excess number of FT was 1.5 (95% CI 1.0-2.2). LRTIs up to 7 years were associated with an absolute increase of 0.9 in the mean FT number, the adjusted relative excess being 1.3 (1.0-1.8). Also the questionnaire-based LRTIs (adjusted relative excess 1.3; 95% CI 0.9-1.8) and URTIs (adjusted relative excess 1.4, 1.0-1.8) before the age of 2 years predicted higher occurrence of FT. Findings suggest that early RTIs have a role in the development of dental caries in permanent teeth.
OBJECTIVES: This study assessed the role of polyvinyl chloride (PVC) plastics and textile materials in the home in the development of bronchial obstruction during the first 2 years of life. METHODS: The study was a matched pair case-control study based on a cohort of 3754 newborns in Oslo in 1992 and 1993 who were followed up for 2 years. The case group consisted of 251 children with bronchial obstruction; the control group was matched one-to-one for date of birth. RESULTS: In conditional logistic regression analysis, the risk of bronchial obstruction was related to the presence of PVC flooring (adjusted odds ratio [OR] = 1.89; 95% confidence interval [CI] = 1.14, 3.14) and textile wall materials (adjusted OR = 1.58; 95% CI = 0.98, 2.54). The reference category was wood or parquet flooring and painted walls and ceiling. Further analysis revealed an exposure-response relationship between the assessed amount of PVC and other plasticizer-containing surface materials and the risk of bronchial obstruction. CONCLUSIONS: This study provides new evidence of the role of PVC and textile wall materials in the development of bronchial obstruction in young children.
OBJECTIVES: The purpose of this study was to assess the role of siblings in day care as a determinant of infants' risk of lower respiratory tract infections. METHODS: A total of 3238 children (86%) out of 3754 Oslo, Norway, newborns recruited in 1992/93 were followed for 1 year. RESULTS: In logistic regression analysis, the risk of infection was increased in (1) infants with one or more siblings compared with infants without siblings (adjusted odds ratio [OR] = 2.3; 95% confidence interval [CI] = 1.84, 2.85) and (2) infants with one or more siblings in day care compared with infants with siblings not in day care (adjusted OR = 1.7; 95% CI = 1.21, 2.26). CONCLUSIONS: The results suggest that siblings in day care outside the home increase infants' risk of lower respiratory tract infections.
Effects of low-level air pollution were studied in one polluted city and two reference cities in northern Finland by comparing the frequency of upper respiratory infections over a 12-month period in 1982 as reported by parents of children ages 14 through 18 months (n = 679) and 6 years (n = 759). A similar comparison was carried out between children living in the more polluted and less polluted areas of the polluted city. The annual mean and the greatest half-hour concentrations of sulfur dioxide (23 and 807 micrograms/m3), particulates (31 and 291 micrograms/m3), nitrogen oxides (15 and 160 micrograms/m3), and hydrogen sulfide (2 and 177 micrograms/m3) in the polluted city were mainly due to industrial sources. In the reference cities, air pollution was produced mainly by traffic and heating. Adjusted odds ratios (OR) for one or more upper respiratory infections of residents in the polluted city vs those in the reference cities were 2.0 (95% confidence interval [CI] = 1.3-3.2) in the younger age group and 1.6 (95% CI = 1.1-2.1) in the older age group. Within the polluted city, OR calculated for living in more vs less polluted areas were 2.0 (95% CI = 1.0-4.0) in the younger and 1.6 (95% CI = 1.0-2.7) in the older children. The present results suggests that, for children, air pollution can be hazardous in concentrations lower than those recorded in earlier studies from Britain and central Europe. The synergistic effect of sulfur dioxide, particulates, nitrogen oxides, hydrogen sulfide, and other pollutants may be a contributing factor.
Comment In: American Journal of Public Health. 1992 Jun;82(6):896-897
OBJECTIVES: The relation between the presence of plastic wall materials in the home and respiratory health in children was assessed. METHODS: This population-based cross-sectional study involved 2568 Finnish children aged 1 to 7 years. RESULTS: In logistic regression models, lower respiratory tract symptoms--persistent wheezing (adjusted odds ratio [OR] = 3.42, 95% confidence interval [CI] = 1.13, 10.36), cough (OR = 2.41, 95% CI = 1.04, 5.63), and phlegm (OR = 2.76, 95% CI = 1.03, 7.41)--were strongly related to the presence of plastic wall materials, whereas upper respiratory symptoms were not. The risk of asthma (OR = 1.52, 95% CI = 0.35, 6.71) and pneumonia (OR = 1.81, 95% CI = 0.62, 5.29) was also increased in children exposed to such materials. CONCLUSIONS: Emissions from plastic materials indoors may have adverse effects on the lower respiratory tracts of small children.