The Relationship of Airways Responsiveness to Cold Air, Cigarette Smoking, and Atopy to Respiratory Symptoms and Pulmonary Function in Adults

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Abstract
The response to eucapnic hyperventilation with subfreezing air was studied in a population based sample of 171 adults, all of whom also completed a respiratory questionnaire, spirometry and skin testing. A positive response to the cold air challenge was defined as((initial FEV1[forced expiratory vol in 1 s]-postchallenge FEV1)/initial FVC [forced vital capacity]) .times. 100 .gtoreq. 9%. Cigarette smoking was associated with a positive cold air response: 12 of 128 current and ex-smokers (9.4%) vs. 1 of 43 nonsmokers (2.3%) (P = 0.095). Among current and ex-smokers, a positive response to the cold air challenge was significantly associated with asthma (P = 0.046). Using a logistic regression model, both current smoking and response to cold air were significant predictors of the presence of persistent wheeze or asthma. A positive skin test to any of the 4 environmental antigens used (ragweed, housedust, trees and grasses) was significantly associated with cigarette smoking (P = 0.018) and hay fever (P = 0.003 among current and ex-smokers) but not with wheezing or asthma. Though not statistically significant, cold air responders had a lower percentage of positive skin test reactivity than nonreactors. The findings of this cross-sectional analysis suggest that in adults, both airways responsiveness and cigarette smoking are important predictors of wheezing and asthma. Evidently, airway hyperresponsiveness and atopy are independent traits. In adults, these traits are associated with cigarette smoking, a comon environmental exposure.