Associations of Cough Prevalence with Ambient Polycyclic Aromatic Hydrocarbons, Nitrogen and Sulphur Dioxide: A Longitudinal Study

Information on potential cough triggers including environmental irritants is vital for successful management of chronic cough in patients. We investigated the relationship between ambient levels of particulate polycyclic aromatic hydrocarbons (PAH), nitrogen dioxide (NO₂) and sulphur dioxide (SO₂) exposures with cough prevalence. Eighty-three adult patients, who had been physician diagnosed with at least asthma, cough variant asthma and/or atopic cough, were divided into asthma and non-asthma groups. They recorded daily cough symptoms during 4 January-30 June 2011 study period while daily samples of total suspended particles were simultaneously collected by use of glass fiber filters and the particulate PAH content determined by high performance liquid chromatography coupled with a fluorescence detector. Ambient concentrations of NO₂ and SO₂ were obtained from a local monitoring site. Logistic regression models using generalized estimating equations were used to determine population-averaged estimates of association between cough prevalence and ambient pollutant exposures for the two groups. Fully adjusted odds ratios from single pollutant models were 1.083 (95% confidence interval (CI): 1.029, 1.140) and 1.097 (95% CI: 1.016, 1.185) per 0.57 ng/m³ for lag2 PAH exposure, while only for asthma group had significant associations with NO₂ and SO₂ exposures for both lag2 and lag02. Similar associations were observed in multipollutant models. This finding suggests that ambient PAH, NO₂, and SO₂ exposure even at low levels is related to cough prevalence in adult chronic cough patients and may be considered as aggravating factor during clinical management of the condition.