TY - JOUR
T1 - Impact of Landscape Fire Smoke Exposure on Patients With Asthma With or Without Laryngeal Hypersensitivity
AU - Vertigan, Anne E.
AU - Harvey, Erin S.
AU - Beyene, Tesfalidet
AU - Van Buskirk, Joseph
AU - Holliday, Elizabeth G.
AU - Bone, Sarah L.
AU - McDonald, Vanessa M.
AU - Horvat, Jay C.
AU - Murphy, Vanessa E.
AU - Jensen, Megan E.
AU - Morgan, Geoffrey G.
AU - Zosky, Graeme R.
AU - Peters, Matthew
AU - Farah, Claude S.
AU - Jenkins, Christine R.
AU - Katelaris, Constance H.
AU - Harrington, John
AU - Langton, David
AU - Bardin, Philip
AU - Katsoulotos, Gregory P.
AU - Upham, John W.
AU - Chien, Jimmy
AU - Bowden, Jeffrey J.
AU - Rimmer, Janet
AU - Bell, Rose
AU - Gibson, Peter G.
PY - 2023/10
Y1 - 2023/10
N2 - Background: Individuals with asthma experienced severe and prolonged symptoms after the Australian 2019 to 2020 landscape fire. Many of these symptoms, such as throat irritation, occur in the upper airway. This suggests that laryngeal hypersensitivity contributes to persistent symptoms after smoke exposure. Objective: This study examined the relationship between laryngeal hypersensitivity and symptoms, asthma control, and health impacts on individuals exposed to landscape fire smoke. Method: The study was a cross-sectional survey of 240 participants in asthma registries who were exposed to smoke during the 2019 to 2020 Australian fire. The survey, completed between March and May 2020, included questions about symptoms, asthma control, and health care use, as well as the Laryngeal Hypersensitivity Questionnaire. Daily concentration levels of particulate matter less than or equal to 2.5 μm in diameter were measured over the 152-day study period. Results: The 49 participants with laryngeal hypersensitivity (20%) had significantly more asthma symptoms (96% vs 79%; P = .003), cough (78% vs 22%; P < .001), and throat irritation (71% vs 38%; P < .001) during the fire period compared with those without laryngeal hypersensitivity. Participants with laryngeal hypersensitivity had greater health care use (P ≤ .02), more time off work (P = .004), and a reduced capacity to participate in usual activities (P < .001) during the fire period, as well as poorer asthma control during the follow-up (P = .001). Conclusions: Laryngeal hypersensitivity is associated with persistent symptoms, reports of lower asthma control, and increased health care use in adults with asthma who were exposed to landscape fire smoke. Management of laryngeal hypersensitivity before, during, or immediately after landscape fire smoke exposure might reduce the symptom burden and health impact.
AB - Background: Individuals with asthma experienced severe and prolonged symptoms after the Australian 2019 to 2020 landscape fire. Many of these symptoms, such as throat irritation, occur in the upper airway. This suggests that laryngeal hypersensitivity contributes to persistent symptoms after smoke exposure. Objective: This study examined the relationship between laryngeal hypersensitivity and symptoms, asthma control, and health impacts on individuals exposed to landscape fire smoke. Method: The study was a cross-sectional survey of 240 participants in asthma registries who were exposed to smoke during the 2019 to 2020 Australian fire. The survey, completed between March and May 2020, included questions about symptoms, asthma control, and health care use, as well as the Laryngeal Hypersensitivity Questionnaire. Daily concentration levels of particulate matter less than or equal to 2.5 μm in diameter were measured over the 152-day study period. Results: The 49 participants with laryngeal hypersensitivity (20%) had significantly more asthma symptoms (96% vs 79%; P = .003), cough (78% vs 22%; P < .001), and throat irritation (71% vs 38%; P < .001) during the fire period compared with those without laryngeal hypersensitivity. Participants with laryngeal hypersensitivity had greater health care use (P ≤ .02), more time off work (P = .004), and a reduced capacity to participate in usual activities (P < .001) during the fire period, as well as poorer asthma control during the follow-up (P = .001). Conclusions: Laryngeal hypersensitivity is associated with persistent symptoms, reports of lower asthma control, and increased health care use in adults with asthma who were exposed to landscape fire smoke. Management of laryngeal hypersensitivity before, during, or immediately after landscape fire smoke exposure might reduce the symptom burden and health impact.
KW - Asthma
KW - Chronic cough
KW - Inducible laryngeal obstruction
KW - Landscape fire
KW - Laryngeal hypersensitivity
KW - Severe asthma
KW - Vocal cord dysfunction
UR - http://www.scopus.com/inward/record.url?scp=85166928776&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/ARC/LP0882048
UR - http://purl.org/au-research/grants/NHMRC/490057
U2 - 10.1016/j.jaip.2023.06.015
DO - 10.1016/j.jaip.2023.06.015
M3 - Article
C2 - 37329954
AN - SCOPUS:85166928776
SN - 2213-2198
VL - 11
SP - 3107-3115.e2
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 10
ER -
