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Airing in the car / air-conditioning bad in case of CF?

Question
Dear expert team!
As we do not have a car, my daughter (21 months, CF) is only very rarely sitting in a car. After the last car ride two days ago, however, she was completely horse and had a strong and coated cough. She was then coughing every night very much and woke up therefore regularly. At the physiotherapy yesterday (hopping on the Pezzi ball) I realized, that she was "bubbling" in the lungs and at each breath I felt/heard wheezing. Today it is better again. My question is: can such a thing occur spontaneously because of the air-conditioning in the car or does it rather have another reason (getting cold or similar things)? Should the usage of the air-conditioning in the car be rather dehorted generally in case of CF patients in the summer? I have to add, that my daughter is in general doing very well and that she coughs seldomly to never, and has no (detectable) mucus! The CF center is very content with her health condition!
Many thanks for your answer,
Best regards,
M.L.
Answer
Hello,
you ask, if the air-conditioning of a car could be problematic for CF patients, as you observed, that your 21-month-old daughter started to be hoarse and to cough increasingly with wheezing two days after the last car ride. These complaints would have decreased again in the meantime.
The air-conditioning device of a car can have unfavourable consequences for several reasons on the health status of CF patients. The first remark concerns the filter systems of the airing and air-conditioning of the car. If the filters of the airing and air-conditioning are not routinely maintained and changed according to the instructions of the manufacturers, it can come to a contamination with mould fungi of the device, that represents a health risk for CF patients however of course also for all healthy passengers.
The second advice that has to be taken into account concerns the setting of the air-conditioning device. Here, mistakes are made especially in case of extreme heat. The temperature of the air-conditioning should be adjusted like this, that the whished temperature of the inside is not decreased more than 6 degrees celsius compared to the outside temperature in a first step, as a massive temperature difference leads in single cases to a narrowing of the bronchi of the patients and is answered by coughing and wheezing. Furthermore, the cold air stream of the air-conditioning should not be
targeted directly on the body of a patient.
In your special case it is not possible to clarify, why your daughter showed intermittently hoarseness and wheezing. The complaints could also be caused by environmental factors, that are related to the car ride and the associated change of places. Probably she got infected at that timepoint with a slight virus infection.
I think you should discuss the "filter problem" with the respective owner of the car, as the observation did worry you and your are probably depending on other rides with the respective car.
Beat regards,
Dr. H.-G. Posselt
21.08.2014