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PubMed1975

The importance of environmental conditions, especially temperature, in the operating room and intensive care ward.

Although most patients are essentially well enough to be able to resist or to adapt to unfavourable ambient conditions, this may not be so with an ill patient or one who is having or has had a serious operation. The climatic conditions necessary in the operating room to give an optimal environment are discussed. These are second in importance only to control of infectivity. Air-conditioning in operating suites should be obligatory; there is even official acceptance of this. Earlier recommendations that the operating room should be heated to up to 80 degree F (27-9 degree C) are obsolete. The temperature most favoured by surgeons is 18-5-21 degree C; some prefer a range of 21-22 degre C. The critical ambient temperature desirable is 21 degree C. For infants and children this may be increased up to 24 degree C. It is difficult or impossible to achieve climatic conditions in the operating room that are acceptable to all. The needs of the patient are of special importance and are largely neglected; he alone is unable to speak for himself. The disposition of air inlets in the operating room is fully discussed. Climatic conditions in the intensive care unit are of great importance and are discussed. The need for full air-conditioning is absolute although this is often ignored. The delivery of conditioned air within the intensive care unit is also fully presented, especially the need to avoid direct chilling of the patient. The advantages of horizontal laminar air flow are presented.

Air Conditioning↗
PubMed1987

The relationship of air hygiene in stables to lower airway disease and pharyngeal lymphoid hyperplasia in two groups of Thoroughbred horses.

The relationship between air hygiene within two types of identically managed horse housing and the incidence of covert respiratory disease (as revealed by endoscopic examination) of their inhabitants was assessed. The horses were all under the supervision of the same trainer. In one yard the design ensured the boxes were well ventilated in still air conditions. In the other yard the boxes were insulated and there was little provision for natural ventilation in still air conditions. There was heavy fungal and actinomycete contamination of wood shavings in the heavily insulated, poorly ventilated housing but not in the shavings of better ventilated boxes. There was increased incidence and severity of mucopus in the tracheas of horses stabled in the contaminated environment over that seen in the other group. There was no such association between the incidence or degree of pharyngeal lymphoid hyperplasia and the two environments or between the degree of tracheal mucopus and PLH found in the 72 horses examined in this study.

Actinomycetales↗
PubMed1989

[Background of low-level gamma-ray spectrometer due to the atmospheric 220Rn and 222Rn].

In connection with low-level gamma-ray counting of natural samples, background due to 220Rn- and 222Rn-daughters was monitored. The results obtained for 4 months showed that the background gamma-ray from 222Rn-daughters was more variable than that of 220Rn-daughters. An efficient air-conditioning was helpful to keep the background stable. It was practically equivalent to the use of N2-gas. Radiometric data for dust samples filtered from the laboratory air suggested that Rn-daughters tended to be removed by air-conditioning.

Air Pollutants↗
PubMed2002

Air intake contamination by building exhausts: tracer gas investigation of atmospheric dispersion models in the urban environment.

The establishment of a safe distance between sources of pollution and air intakes is based on a complex exercise that should take into account several wind, physical, and topographical factors. To estimate the maximum concentrations of the pollutants as a function of the distance from the emission source, some heating, ventilation, and air conditioning (HVAC) system designers use the atmospheric dispersion models suggested by the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE). Two of these models, the Halitsky and Wilson-Chui-Lamb models, have been developed and evaluated mainly with laboratory data. There have been relatively few evaluations with full-scale field data. The objective of this study, carried out on a building in downtown Montreal, Quebec, Canada, was to compare the measured concentrations of a tracer gas emitted by an exhaust stack with those predicted by these models. The results indicate that the Halitsky model gives lower than actual dilution, while the Wilson-Chui-Lamb model generally gives acceptable estimates, with occasional over-estimations of the dilution.

Air Pollution↗
PubMed1999

Ozone decay rates in residences.

In urban and suburban settings, indoor ozone exposures can represent a significant fraction of an individual's total exposure. The decay rate, one of the factors determining indoor ozone concentrations, is inadequately understood in residences. Decay rates were calculated by introducing outdoor air containing 80-160 parts per billion ozone into 43 residences and monitoring the reduction in indoor concentration as a function of time. The mean decay rate measured in the living rooms of 43 Southern California homes was 2.80 +/- 1.30 hr-1, with an average ozone deposition velocity of 0.049 +/- 0.017 cm/sec. The experimental protocol was evaluated for precision by repeating measurements in one residence on five different days, collecting 44 same-day replicate measurements, and by simultaneous measurements at two locations in six homes. Measured decay rates were significantly correlated with house type and the number of bedrooms. The observed decay rates were higher in multiple-family homes and homes with fewer than three bedrooms. Homes with higher surface-area-to-volume ratios had higher decay rates. The ratio of indoor-to-outdoor ozone concentrations in homes not using air conditioning and open windows was 68 +/- 18%, while the ratio of indoor-to-outdoor ozone was less than 10% for the homes with air conditioning in use.

Air Pollution, Indoor↗
PubMed2005

Evaluation of ionic air purifiers for reducing aerosol exposure in confined indoor spaces.

UNLABELLED: Numerous techniques have been developed over the years for reducing aerosol exposure in indoor air environments. Among indoor air purifiers of different types, ionic emitters have gained increasing attention and are presently used for removing dust particles, aeroallergens and airborne microorganisms from indoor air. In this study, five ionic air purifiers (two wearable and three stationary) that produce unipolar air ions were evaluated with respect to their ability to reduce aerosol exposure in confined indoor spaces. The concentration decay of respirable particles of different properties was monitored in real time inside the breathing zone of a human manikin, which was placed in a relatively small (2.6 m3) walk-in chamber during the operation of an ionic air purifier in calm air and under mixing air condition. The particle removal efficiency as a function of particle size was determined using the data collected with a size-selective optical particle counter. The removal efficiency of the more powerful of the two wearable ionic purifiers reached about 50% after 15 min and almost 100% after 1.5 h of continuous operation in the chamber under calm air conditions. In the absence of external ventilation, air mixing, especially vigorous one (900 CFM), enhanced the air cleaning effect. Similar results were obtained when the manikin was placed inside a partial enclosure that simulated an aircraft seating configuration. All three stationary ionic air purifiers tested in this study were found capable of reducing the aerosol concentration in a confined indoor space. The most powerful stationary unit demonstrated an extremely high particle removal efficiency that increased sharply to almost 90% within 5-6 min, reaching about 100% within 10-12 min for all particle sizes (0.3-3 microm) tested in the chamber. For the units of the same emission rate, the data suggest that the ion polarity per se (negative vs. positive) does not affect the performance but the ion emission rate does. The effects of particle size (within the tested range) and properties (NaCl, PSL, Pseudomonas fluorescens bacteria) as well as the effects of the manikin's body temperature and its breathing on the ionic purifier performance were either small or insignificant. The data suggest that the unipolar ionic air purifiers are particularly efficient in reducing aerosol exposure in the breathing zone when used inside confined spaces with a relatively high surface-to-volume ratio. PRACTICAL IMPLICATIONS: Ionic air purifiers have become increasingly popular for removing dust particles, aeroallergens and airborne microorganisms from indoor air in various settings. While the indoor air cleaning effect, resulting from unipolar and bipolar ion emission, has been tested by several investigators, there are still controversial claims (favorable and unfavorable) about the performance of commercially available ionic air purifiers. Among the five tested ionic air purifiers (two wearable and three stationary) producing unipolar air ions, the units with a higher ion emission rate provided higher particle removal efficiency. The ion polarity (negative vs. positive), the particle size (0.3-3 microm) and properties (NaCl, PSL, Pseudomonas fluorescens bacteria), as well as the body temperature and breathing did not considerable affected the ionization-driven particle removal. The data suggest that the unipolar ionic air purifiers are particularly efficient in reducing aerosol exposure in the breathing zone when they are used inside confined spaces with a relatively high surface-to-volume ratio (such as automobile cabins, aircraft seating areas, bathrooms, cellular offices, small residential rooms, and animal confinements). Based on our experiments, we proposed that purifiers with a very high ion emission rate be operated in an intermittent mode if used indoors for extended time periods. As the particles migrate to and deposit on indoor surfaces during the operation of ionic air purifiers, some excessive surface contamination may occur, which introduces the need of periodic cleaning these surfaces.

Aerosols↗
PubMed1982

Legionellosis--the 1980 San Francisco outbreak.

During the first half of March 1980, an unseasonal outbreak of legionellosis, which involved at least 14 of approximately 1,000 workers, occurred in a 6-month-old office building in San Francisco. An epidemiologic investigation revealed that persons 50 yr of age and older were at increased risk of disease. The outbreak was temporally associated with operation of the building's air conditioning system. In addition, Legionella pneumophila Serogroups 1, 4, and 6 were identified in water samples taken from a rooftop air conditioning cooling tower located directly across the street from an area of recent excavation.

Adult↗
PubMed2001

[Evaluation of absorbed dose-distribution in the X-ray or gamma-irradiator for blood products].

Irradiation of blood products abrogates the proliferation of lymphocytes present in cellular component, which is currently the only accepted methodology to prevent transfusion-associated graft versus host disease (TA-GVHD). A range of irradiation dose levels between 15 Gy and 50 Gy is being used, but the majority of facilities are employing 15 Gy. It should, however, be recognized that the delivered dose in the instrument canister might differ from the actual dose absorbed by the blood bag. This study have evaluated the actual dose distribution under practical conditions where a container was loaded with blood products or water bags, or filled with distilled water. This approach provides data that the maximum attenuation occurred when the container was completely filled with a blood-compatible material. Thus, an error of approximately 20 percent should be considered in the dose measured in the in-air condition. A dose calibration in an in-air condition may lead to substantial underexposure of the blood products. A dose distribution study using adequately prearranged exposure period verified that the absorbed dose of 15 Gy was attained at any point in the container for both linear accelerator and gamma-irradiator. The maximal difference in the absorbed dose between measured points was 1.5- and 1.6-fold for linear accelerator and gamma-irradiator, respectively. In conclusion, using blood-compatible materials, a careful dose calibration study should be employed in which the absorbed dose of 15 Gy is obtained at the point where the lowest dose could be expected.

Blood Cells↗
PubMed1983

Effect of emissions from residential wood stoves on SCE induction in CHO cells.

The SCE-induction capacity of emissions from an airtight horizontal baffled residential wood stove was investigated in CHO cells. The samples were taken under normal and starved air conditions, from burning birch and spruce separately. Both particle phase and vapour phase were collected. All samples induced a dose-related response in SCE both with and without a metabolic activation system, the rat-liver microsomal fraction. The burning conditions in the stove influenced the mutagenicity of the emissions more than the type of wood; the smoke from wood burning under starved air conditions was more than one order of magnitude more potent in inducing a significant SCE response. With all samples, the response in SCE induction was highest without metabolic activation. The toxicity of the samples, especially those without S9, limited the dose-range tested.

Animals↗
PubMed2002

Ventilation and health in non-industrial indoor environments: report from a European multidisciplinary scientific consensus meeting (EUROVEN).

Scientific literature on the effects of ventilation on health, comfort, and productivity in non-industrial indoor environments (offices, schools, homes, etc.) has been reviewed by a multidisciplinary group of European scientists, called EUROVEN, with expertise in medicine, epidemiology, toxicology, and engineering. The group reviewed 105 papers published in peer-reviewed scientific journals and judged 30 as conclusive, providing sufficient information on ventilation, health effects, data processing, and reporting, 14 as providing relevant background information on the issue, 43 as relevant but non-informative or inconclusive, and 18 as irrelevant for the issue discussed. Based on the data in papers judged conclusive, the group agreed that ventilation is strongly associated with comfort (perceived air quality) and health [Sick Building Syndrome (SBS) symptoms, inflammation, infections, asthma, allergy, short-term sick leave], and that an association between ventilation and productivity (performance of office work) is indicated. The group also concluded that increasing outdoor air supply rates in non-industrial environments improves perceived air quality; that outdoor air supply rates below 25 l/s per person increase the risk of SBS symptoms, increase short-term sick leave, and decrease productivity among occupants of office buildings; and that ventilation rates above 0.5 air changes per hour (h-1) in homes reduce infestation of house dust mites in Nordic countries. The group concluded additionally that the literature indicates that in buildings with air-conditioning systems there may be an increased risk of SBS symptoms compared with naturally or mechanically ventilated buildings, and that improper maintenance, design, and functioning of air-conditioning systems contributes to increased prevalence of SBS symptoms.

Air Pollution, Indoor↗
PubMed2000

Use of the near-infrared reflectance method for measurement of moisture content during granulation.

The purpose of this study was to demonstrate the use of a near-infrared (NIR) method for in-process control of a placebo formulation. An NIR setup with a multichannel detector was applied in the measurement of water during fluidized bed granulation. The effects of two critical granulation parameters were studied using the central composite design. The present NIR setup with three wavelengths proved applicable for in-line moisture measurement. The 1990 nm signal was used for measurement of water and the 1745 and 2145 nm signals were used to correct the change in spectra baseline during granulation. Variations in inlet air conditions proved to be critical factors, explaining differences in the granule size distributions. Differences in granule moistening and drying rates resulting from varying inlet air conditions could be measured with the NIR setup. The moisture content of granules at the end of the spraying phase explained part of the differences in granule size distributions. The moisture content of granules at the end of the drying phase affected the tableting behavior of granules. The results suggested that direct measurement of granule moisture content facilitates the in-process control of the granulation.

Drug Compounding↗
PubMed1990

Measurements of certain environmental tobacco smoke components on long-range flights.

In December 1987, 10 portable nicotine and respirable particle measuring instruments were employed on 4 Boeing 747 flights, placed in all passenger classes and zones, in randomly selected non-perimeter seats, to assess environmental tobacco smoke (ETS). Measurements integrated the nicotine particle concentrations over the duration of the 5-h Tokyo-Hong Kong-Tokyo flights and over each half of the 14-h New York City-Tokyo flights. Number of cigarettes smoked per minute in sample areas explained a significant proportion of variability in the observed nicotine and respirable particle levels. The all-daytime Tokyo-Hong Kong-Tokyo flights with a different seating configuration showed higher levels of ETS variables. The cause cannot be identified from the six flight segments studied. Levels of ETS observed in these 747-100 and -200 flights (with all air conditioning packs operating) were lower than those observed in narrow body 727/737 aircraft, on short flights, in prior related tests. The 747's five air conditioning zones are reasonably effective in keeping ETS within the respective zones, and discharging it with relatively little entry into non-smoking areas.

Aircraft↗
PubMed1986

[Expansion behavior of intravitreous sulfur hexafluoride in exposure to nitrous oxide].

In experiments with 19 rabbits the changes in volume and concentration of intravitreously instilled sulfur hexafluoride were investigated under normal air conditions (10 rabbits in group A) and with application of laughing, gas to the inspiration system for 3 hours (9 rabbits in group B). Under normal air conditions the SF6 gas bubble attained its greatest volume after 24 hours (twice its initial volume). With the addition of 67% laughing gas to the inspiration system the largest expansion in volume (260%) was found after 3 hours, i.e., at the end of application of laughing gas, and was followed by another peak after 24 hours. With regard to the sulfur hexafluoride concentration in the gas bubble, the results in the two groups were similar. The authors conclude that in retinal surgery with application of sulfur hexafluoride general anesthesia should not include laughing gas.

Animals↗
PubMed1999

Health effects of sulfur-related environmental air pollution. IV. Respiratory lung function.

Recently concern has been raised about health effects related to environmental sulfur and/or acidic aerosols. To assess long-term effects on respiratory lung function, 8 beagle dogs were exposed over a period of 13 mo for 16.5 h/day to 1-microm neutral sulfite aerosol with a particle-associated sulfur(IV) concentration of 0.32 mg m(-3) and for 6 h/day to 1.1-microm acidic sulfate aerosol providing an hydrogen ion concentration of 15.2 micromol m(-3) for inhalation. Prior to exposure the dogs were kept under clean air conditions for 16 mo to establish physiological baseline values for each dog. A second group of eight dogs (control) was kept for the entire study under clean air conditions. Before and at the end of exposure, respiratory lung function was evaluated in both groups in anesthetized and mechanically ventilated animals. Lung volumes as well as static and dynamic lung compliances were measured. Series dead-space volumes and slopes of the alveolar plateau for respiratory (O2, CO2) and inert test gases (He, SF6) were determined from single-breath washout tracings. Monodisperse 0.9-microm DEHS droplets were used to assess convective mixing in the lungs and to evaluate airway dimensions in vivo. Gas exchange across the alveolar-capillary layer was characterized by membrane diffusing capacity for carbon monoxide and alveolar-arterial pressure differences for respiratory gases. A bronchial challenge with carbachol was used to assess airway responsiveness. In comparison to the control group, dogs exposed to sulfur(IV) and acidic aerosol exhibited no significant changes in any respiratory lung function parameter. Also the responsiveness of the bronchial airways to carbachol was not affected. In view of the results obtained in this and previous studies, we conclude that anticipated synergistic effects of the two air pollutants on pulmonary lung function were not observed. It is hypothesized that antagonistic effects of the air pollutants on the activity of phospholipase A2 play an important role and account for counteracting physiological compensatory mechanisms. The results emphasize the complexity of health effects on lung function in response to the complex mixtures of ambient air pollutants and witness the precariousness in the risk assessment of air pollutants for humans.

Aerosols↗
PubMed1999

Health effects of sulfur-related environmental air pollution. II. Cellular and molecular parameters of injury.

Recently, concern has been raised about effects related to environmental sulfur and/or acidic aerosols. To assess long-term effects on nonrespiratory lung function, 8 beagle dogs were exposed over a period of 13 mo for 16.5 h/day to a neutral sulfite aerosol at a sulfur(IV) concentration of 0.32 mg m(-3) and for 6 h/day to an acidic sulfate aerosol providing a hydrogen concentration of 15.2 micromol m(-3) for inhalation. Prior to exposure the dogs were kept under clean air conditions for 16 mo to establish physiological baseline values for each animal. A second group of eight dogs (control) was kept for the entire study under clean air conditions. No clinical symptoms were identified that could be related to the combined exposure. Biochemical and cellular parameters were analyzed in sequential bronchoalveolar lavage (BAL) fluids. The permeability of the alveolo-capillary membrane and diethylenetriaminepentaacetic acid (DTPA) clearance was not affected. Similarly, oxidant burden of the epithelial lining fluid evaluated by levels of oxidation products in the BAL fluid protein fraction remained unchanged. Both the lysosomal enzyme beta-N-acetylglucosaminidase and the alpha-1-AT were increased (p <.05). In contrast, the cytoplasmic marker lactate dehydrogenase remained unchanged, indicating the absence of severe damages to epithelial cells or phagocytes. Various surfactant functions were not altered during exposure. Three animals showed elevated levels of the type II cell-associated alkaline phosphatase (AP), indicating a nonuniform response of type II cells. Significant correlations were found between AP and total BAL protein, but not between AP and lactate dehydrogenase, suggesting proliferation of alveolar type II cells. Absolute and relative cell counts in the BAL fluid were not influenced by exposure. Alveolar macrophages showed no alterations with regard to their respiratory burst upon stimulation with opsonized zymosan. The percentage of alveolar macrophages capable of phagocytozing latex particles was significantly decreased (p<.05), while the phagocytosis index was not altered. In view of the results of this and previous studies, we conclude that there is no synergism of effects of these two air pollutants on nonrespiratory lung functions. It is hypothesized that antagonistic effects of these air pollutants on phospholipase A2-dependent pathways account for compensatory physiological mechanisms. The results emphasize the complexity of health effects on lung functions in response to the complex mixture of air pollutants and disclose the precariousness in the risk assessment of air pollutants for humans.

Aerosols↗
PubMed1999

Health effects of sulfur-related environmental air pollution. III. Nonspecific respiratory defense capacities.

Recently concern has been raised about health effects related to environmental sulfur and/or acidic aerosols. To assess long-term effects on respiratory lung function, 8 beagle dogs were exposed over a period of 13 mo for 16.5 h/day to 1.0 microm neutral sulfite aerosol with a particle associated sulfur(IV) concentration of 0.32 mg m(-3) and for 6 h/day to 1.1 microm acidic sulfate aerosol providing an hydrogen ion concentration of 15.2 micromol m(-3) for inhalation. Prior to exposure the dogs were kept under clean air conditions for 16 mo to establish physiological baseline values for each dog. A second group of eight dogs (control) was kept for the entire study under clean air conditions. Nonspecific defense mechanisms in the airways and in the peripheral lung were studied during chronic exposure of the combination of neutral sulfur(IV) and acidic sulfur(VI) aerosols. No functional changes of tracheal mucus velocity were found, in agreement with unchanged morphometry of the airways. However, the exposure resulted in changes of several alveolar macrophage (AM) mediated particle clearance mechanisms: (1) Based on in vivo clearance analysis and cultured AM studies using moderately soluble cobalt oxide particles, intracellular particle dissolution was significantly reduced since phagolysosomal proton concentration was decreased. We deduce exposure-related malfunction of proton pumps bound to the phagolysosomal membrane as a result of an increase of cytosolic proton concentration. (2) Based on in vivo clearance analysis using insoluble polystyrene particles, AM-mediated particle transport from the lung periphery toward ciliated terminal bronchioli and further to the larynx was significantly reduced. Activation of epithelial type II cells at the entrance of alveoli was inferred from observed type II cell proliferation at those alveolar ridges and enhanced secretion of alkaline phosphatase in the fluid of bronchoalveolar lavages. As a result, hypersecretion of chemotactic mediators by activated type II cells at these loci led to the observed decrease of particle transport toward ciliated bronchioli. (3) Based on in vivo clearance analysis using insoluble polystyrene particles, particle transport from the alveolar epithelium into interstitial tissues was increased and (4) particle transport to the tracheobronchial lymph nodes was significantly enhanced. Particle transport into interstitial tissues is the most prominent clearance pathway from the canine alveolar epithelium. We conclude that the deteriorated particle transport toward ciliated terminal bronchioli resulted in an enhanced particle transport across the epithelial membrane into interstitial tissues and the lymphatic drainage. The observed alterations in alveolar macrophage-mediated clearance mechanisms during chronic exposure of these air pollutants indicate an increased risk of health.

Aerosols↗
PubMed1997

[Exposure of the pediatric surgeon to inhalation-anesthetic during pediatric bronchoscopy procedures].

BACKGROUND: General anaesthetic agents are frequently used for paediatric bronchoscopy. A disadvantage of this open system anaesthesia seems to be the contamination of the working environment. The aim of this study was to determine the exposure of the endoscopist during paediatric bronchoscopy under general anaesthesia in different working environments and to compare these measurements with the currently valid international threshold limit values. MATERIAL AND METHODS: 25 children (ASA I-III) scheduled for diagnostic bronchoscopy were included in the study. After inhalational induction all children were intubated with a nonflexible bronchoscope and manually ventilated through a side arm of the bronchoscope. Maintenance of anaesthesia was achieved with sevoflurane (2-3 vol%) in 80% oxygen. Trace concentrations were measured every 90 seconds in the breathing zones of the paediatrician by means of a highly sensitive direct-reading instrument (Brüel & Kjaer 1302). The lower detection limit was 0.02 ppm. The investigation was done in an OT with and without air conditioning and scavening system. RESULTS: The mean age of the children was 50.3 months (range: 3-109 months). Ventilation and oxygenation were stable throughout the bronchoscopic procedure. Mean exposure of the paediatrician without air-conditioning and scavening system to sevoflurane was over 50 ppm for the endoscopist. All international threshold limit values were exceeded. Peak concentrations higher than 100 ppm sevoflurane were detected repeatedly in 40% of anaesthesias. During bronchoscopy in the operating room equipped with laminar air flow (20.2 air exchanges per hour) and narcotic gas evacuation (30 l/min) the mean exposure of the paediatrician was 26.4 ppm sevoflurane. CONCLUSIONS: The main finding of the present study is that under inhalation anaesthesia with sevoflurane for paediatric bronchoscopy occupation exposure is higher than the limits stated in all known health regulation guidelines. Therefore, in case of such working conditions, the use of total intravenous anaesthesia is advocated also in very small infants.

Adult↗
PubMed1985

Airway cooling as the stimulus to exercise-induced asthma--a re-evaluation.

Exercise-induced asthma (EIA) was recorded in 20 of 22 asthmatic children who cycled for 8 min while inspiring hot (32-40 degrees C) dry (3-10 mg H2O L-1) air. The mean +/- 1SD reduction in forced expiratory volume in one second was 39.8% +/- 22.3 of the pre-exercise value. To determine the relationship between respiratory heat loss (RHL) and retrotracheal temperature (RTT) under these inspired air conditions we studied 11 non-asthmatic adults who performed steady-state and incremental bicycle exercise. Exercise tests were also carried out while inspiring cold dry air. At the equivalent RHL, RTT was reduced by only 0.1 +/- 0.35 degrees C breathing hot air compared with 1.0 +/- 0.81 degrees C when cold air was inhaled. These data suggest that abnormal cooling of the airways is not occurring during the inhalation of hot dry air. Thus an additional stimulus to airway cooling must have been acting to induce asthma in the children. We propose that water loss and not heat loss is the stimulus to EIA under these inspired air conditions.

Adolescent↗