Positive influence of the air at the North sea

Question

Dear,

I have 2 questions
- Can the composition of the air in the area of the North sea diminish respiratory symptoms in patients with CF?
- Is there a positive influence of the composition of the air at the North sea (salt-iodine) on the progress of lung damage in patients with CF?
I realise that there are probably few scientific studies that can support your answer. Thank you!

Kind regards,

Answer

Dear questioner,

Thanks for these interesting questions. As you suggest, indeed the number of scientific studies to support the answer to your question is limited.

The degree of lung disease in patients with CF is the result of a complex interaction between genetic factors and environmental factors and is usually expressed by the lung function parameter FEV1 (the maximal amount of air you can blow out after full inspiration) .

Examples of environmental factors that influence the course of lung disease in CF are the socio-economic status of the patient, the treatment regimen, the presence of chronic infection with Pseudomonas aeruginosa, the treatment adherence of the patient, the age at the time of diagnosis etc. Also the role of air pollution has been studied. It is well known and well proven that exposure to cigarette smoke will cause a faster deterioration of lung function. It is also known that patients who live in regions with a lot of air pollution have a higher risk of exacerbations and a worse course of lung disease. Air pollution is higher in densely populated and industrial areas. But scientific proof that the air at the sea and specifically at the North sea is healthier than the air elsewhere is not available.

The quality of the air thus explains a small part in the evolution of lung disease in patients with CF. But most people, also people with CF, do like to spend some time at the seaside. It is beautiful there, one is active, one has more time. And also these factors can have a positive influence on the course of CF.

For those who want even more information about the influence of genetic factors and environmental factors, we provide this extra little bit of information: the large variability in lung disease severity between patients carrying exactly the same CFTR mutation is half attributed to other genetic factors (called modifier genes) and half attributed to environmental factors (Colacco, J Pediatr 2010;157:802-7). And of course of these environmental factors the quality of the air is a small part.

Best regards,

F Vermeulen, K De Boeck

01.09.2011