Immediate effects of second-hand smoke on the mechanics of tidal breathing
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School of Medicine, National and Kapodistrian University of Athens, Athens
George D. Behrakis Research Lab, Hellenic Cancer Society, Athens
Institute of Public Health, The American College of Greece, Athens
Athens Medical Center, Athens, Greece
Melpo Kapetanstrataki   

17B Ipitou street, 10557, Athens, Greece
Pneumon 2020;33(3):118–130
Limited studies have examined the implications of Second-Hand Smoke (SHS) on lung function; majority used traditional diagnostic lung function tests requiring forced respiratory manoeuvres. Aim of our study was to assess the immediate effects of exposure to SHS on the respiratory mechanics during tidal breathing.

20 healthy non-smokers 18-45-years-old participated in four exposure sessions; 10 minutes in 250 μg/m3 PM2.5 (10/250), 20 minutes in 250 μg/mPM2.5 (20/250), 10 minutes in 500 μg/mPM2.5 (10/500) and 20 minutes in 500 μg/m3 PM2.5 (20/500). A pre and an immediately post exposure IOS measurement were obtained. Differences in Impulse Oscillometry (IOS) parameters pre and post exposure for each session were assessed with paired t-tests or Wilcoxon tests. Differences between exposure sessions were assessed with mixed linear models. Analysis was performed in Stata 14.

Statistically significant differences were observed in IOS parameters in all exposure sessions, with most changes observed in 10/500 and least in 20/500 session. Analysis between sessions showed significantly different results between 20/250 compared to 10/250 session in many IOS parameters, while 10/500 differed statistically significantly to 10/250 only in R10 inspiratory.

Present study is the first to show that acute exposure of healthy non-smokers to SHS leads to alterations of resting breathing mechanics, successfully captured by IOS. Alterations were expressed by increased Resistance of peripheral and central airways, findings suggestive of a likely broncho-constrictive response to the irritative inhalant. A mild, linear effect of exposure duration was found, while no clear effect was observed for the level of exposure.

ATS/ERS: American Thoracic Society/European Respiratory Society, AX: Reactance Area, BMI: Body Mass Index, COPD: Chronic obstructive pulmonary disease, EBC: Exhaled Breath Condensate, FeNO: Exhaled Nitrogen Oxide, fdr: Frequency Dependence of Resistance, FRC: Functional Residual Capacity, fres: Resonant Frequency, IOS: Impulse Oscillometry, IQR: Inter-quartile range, R5: Resistance at 5 Hz, R10: Resistance at 10 Hz, R20: Resistance at 20 Hz, SD: Standard deviation, SHS: Second-Hand Smoke, 10/250: exposure for 10 min. in a 250 μg/m3 concentration of PM2.5, 20/250: exposure for 20 min. in a 250 μg/m3 concentration of PM2.5, 10/500: exposure for 10 min. in a 500 μg/m3 concentration of PM2.5, 20/500: exposure for 20 min. in a 500 μg/m3 concentration of PM2.5, X5: Distal Capacity Reactance at 5 Hz, X20: Reactance at 20 Hz, Z5: Total Impedance at 5 Hz
All authors declare that no funding was received for the work described in this manuscript
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