Airway inflammation can be demonstrated by the modem method of sputum induction using ultrasonic nebulizer and hypertonic saline. We studied whether compressed-air nebulizer and isotonic saline which are commonly available and cost less, are as effective in inducing sputum in normal adult subjects as the above mentioned tools. Sixteen subjects underwent weekly sputum induction in the following manner: ultrasonic nebulizer (Medix Sonix 2000, Clement Clarke, UK) using hypertonic saline, ultrasonic nebulizer using isotonic saline, compressed-air nebulizer (BestNeb, Taiwan) using hypertonic saline, and compressed-air nebulizer using isotonic saline. Overall, the use of an ultrasonic nebulizer and hypertonic saline yielded significantly higher total sputum cell counts and a higher percentage of cell viability than compressed-air nebulizers and isotonic saline. With the latter, there was a trend towards squamous cell contaminations. The proportion of various sputum cell types was not significantly different between the groups, and the reproducibility in sputum macrophages and neutrophils was high (Intraclass correlation coefficient, r [95%CI]: 0.65 [0.30-0.91] and 0.58 [0.22-0.89], p < 0.001). Overall changes in median FEV, were small and comparable between all groups. Induction using ultrasonic nebulizers together with hypertonic saline was generally less well tolerated than compressed-air nebulizers and isotonic saline. We conclude that in normal subjects, although both nebulizers and saline types can induce sputum with reproducible cellular profile, ultrasonic nebulizers and hypertonic saline are more effective but less well tolerated.
In the last few years, air within homes have been indicates by various and emerging body as more serious polluted than those outdoor. Prevalence of respiratory inflammation among school children aged 8 and 10 years old attending national primary schools in urban and rural area were conducted in Klang Valley. Two population studies drawn from the questionnaires were used to investigate the association between indoor particulate matter (PM2.5 & PM10) in a home environment and respiratory implication through the understanding of biological responses. Approximately 430 healthy school children of Standard 2 and Standard 5 were selected. Indication of respiratory symptoms using adaptation questionnaire from American Thoracic Society (1978). Sputum sample collection taken for biological analysis. IL-6 then was analyse by using ELISA techniques. Indoor PM2.5 and PM10 were measured using Dust Trak Aerosol Monitor. The mean concentration of PM2.5 (45.38 µg/m3) and PM10 (80.07 µg/m3) in urban home environment is significantly higher compared to those in rural residential area (p=0.001). Similar trend also shows by the prevalence of respiratory symptom. Association were found with PM2.5 and PM10 with the level of IL-6 among school children. A greater exposure to PM2.5 and PM10 are associated with higher expression of IL-6 level suggesting that the concentration of indoor particulate in urban density area significantly influence the health of children.