Respiratory pathology in children inhalationally exposed to irritating substances

Background: The investigation of the features of the course of the respiratory pathology in children who are chronically exposed to fine dust is an issue of current importance due to high prevalence of respiratory diseases and unfavorable environmental conditions.

Aim: To scrutinize clinical features of the clinical course of respiratory diseases in children who are chronically exposed to fine dust (PM10) and irritating chemicals (nitrogen dioxide, ammonia, hydrogen chloride).

Methods: We used a set of clinical laboratory testing and instrumental examination (rhinomanometry, spirography) methods. We examined a total of 180 children (aged 3 to 7 years) with allergic rhinitis (J30.3) and hypertrophy of the palatine and nasopharyngeal tonsils (J35.0 and J35.2) (44.9% of the patients were girls, 55.1% were boys), who were residing in areas with high levels of ambient air pollution by particulate matter (PM10) and chemicals such as nitrogen dioxide, hydrogen chloride and ammonia (a study group). A control group included 100 children with a similar pathology, residing in relatively unpolluted areas. The age and sex distributions were similar in both groups.

Results: We observed a higher prevalence of upper respiratory tract diseases in the area with high levels of air pollution by fine dust and the chemicals having an irritating effect (nitrogen dioxide, hydrogen chloride and ammonia) in comparison with relatively unpolluted areas. We have determined the features of the clinical course of the upper respiratory tract pathologies – a combination of respiratory symptoms with signs of asthenic and neurotic syndrome, the absence of seasonality of exacerbations, resistance to standard treatment methods, clinical signs of hypoxia and intoxication, lymphadenopathy, increased lipid peroxidation, decreased AOA in the blood and reduced superoxide dismutase activity, increased malondialdehyde (MDA) and methaemoglobin levels, mild inflammatory changes on the complete blood count, reduced nonspecific resistance, the imbalance of cellular and humoral immunity, a reduction in the total nasal airflow rate according to a rhinomanometry examination, mild restrictive and obstructive signs of impaired respiration function, inflammatory changes in the mucous membranes of the paranasal sinuses such as swelling, exudation and fibrous changes.

Conclusion: The identified features of the clinical course of respiratory diseases indicate a more severe course of respiratory pathologies in the children who are chronically exposed to fine dust and irritating chemicals (nitrogen dioxide, ammonia and hydrogen chloride) and the necessity to use a comprehensive approach when providing treatment and prevention