Chest
Volume 103, Issue 5, May 1993, Pages 1369-1374
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Clinical Investigations
The Influence of Spring and Summer New England Meteorologic Conditions on the Respiratory Status of Patients With Chronic Lung Disease

https://doi.org/10.1378/chest.103.5.1369Get rights and content

To determine whether meteorologic conditions affect the respiratory status of individuals with chronic lung disease, we asked 14 patients who had completed outpatient pulmonary rehabilitation to record the following information daily during the spring and summer of 1991: (1) dyspnea on arising (morning dyspnea); (2) dyspnea throughout the day (daytime dyspnea); (3) peak expiratory flow rate (PEFR); (4) mood; and (5) the presence of lower respiratory tract infection (LRI). The effect of local meteorologic conditions and LRI frequency on morning and daytime dyspnea, PEFR, and mood were analyzed for spring and summer seasons using a linear regression technique that controlled for first-order autocorrelation. The LRI frequency and the preceding day's respiratory status were the most significant predictors of either season's daily variation in respiratory status. During spring, the only meteorologic condition associated with respiratory status was precipitation: rainfall was directly related to increased morning and daytime dyspnea. Meteorologic conditions were not related to changes in PEFR or mood. During summer, the combination of higher temperature, rise in barometric pressure, and increased LRI frequency best predicted increased morning dyspnea, while the combination of higher temperature and rise in barometric pressure best predicted reduced PEFR. Meteorologic conditions were not related to changes in daytime dyspnea or mood. Precipitation in spring and a combination of high temperature and rise in barometric pressure in summer best predicted deterioration in the respiratory status of this group of patients with chronic lung disease.

Section snippets

Patients

Fourteen patients from the greater Hartford area who had completed an outpatient pulmonary rehabilitation program and were attending weekly exercise maintenance sessions were studied. These patients were selected because they had significant exertional dyspnea despite optimum medical therapy and were considered reliable informants. They were asked to record clinical information daily in a diary from the first day of spring through the last day of summer 1991. This information was returned to

Patients

Demographic information, pulmonary function tests, and measurements of respiratory status over the study period are given in Table 1. Eleven patients had chronic obstructive pulmonary disease, two (patients 10 and 13) had steroid-dependent asthmatic bronchitis, and one (patient 1) had sarcoidosis with pulmonary fibrosis and airways obstruction. All were ex-cigarette smokers; three were receiving continuous, low-flow oxygen therapy. Although a 15 percent or greater improvement in FEV1 following

DISCUSSION

The objective of this investigation was to determine which meteorologic conditions, if any, were associated with changes in the respiratory status of a group of patients with chronic lung disease. Although this group was mixed with respect to diagnoses, they were all ex-smokers with moderate to severe airways obstruction and had persistent dyspnea despite optimal medical therapy. The LRI and mood were also recorded, anticipating their potential confounding influence on respiratory status.

ACKNOWLEDGMENTS

The authors would like to thank Uwe Koehn, Ph. D., Chairman, Department of Statistics, the University of Connecticut, Storrs, and Dennis Kraft, Ph. D., for their invaluable aid with statistical analysis, and Mrs. Darcy Wright for endless hours of data entry.

REFERENCES (21)

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Manuscript received April 27; revision accepted September 15.

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