Mucociliary Clearance, Airway Inflammation and Nasal Symptoms in Urban Motorcycle-drivers
Condition: Attitude to Health
MeSH terms: Inflammation
Study type: Interventional

Summary: 
      Professionals working in polluted areas may present increased airways symptoms and
      dysfunction. Rhinopharyngeal retrograde clearance (RRC) has been used to improve mucus
      clearance in infants with bronchitis and bronchiolitis. Flushing the nasal cavity with saline
      (S) has been used to reduce nasal inflammation in rhinitis and sinupathies. The aim of this
      study was to assess the effects of RRC and RRC plus S (RRC+S) on the airways in professional
      motorcyclists. Twenty-four male motorcyclists (mean age 36 years) were randomly assigned to
      RRC or RRC+S. Subjects were assessed at baseline and 15 days after interventions for airways
      assessments by saccharin test, mucus contact angle, cellularity in nasal lavage and airways
      symptoms with the use of SNOT-20 questionnaire. Data were analyzed by nonparametric ANOVA for
      repeated measures with Bonferroni´s correction. A passive nitrogen dioxide monitoring system
      was used to assess the mean personal air pollution exposure along the study period (NO2). The
      association between NO2 and the airways outcomes was analyzed by Spearman correlation test.
      At baseline, the two groups were similar in clinical, demographics and working aspects. From
      them, 100% had airways symptoms complaints and 33% had nasal MCC impairment. After
      treatments, both groups presented improvements in airways symptoms and nasal MCC. However,
      increased number of macrophages and ciliated cells were observed in nasal lavage of both
      groups. No associations between nitrogen dioxide and the outcome variables were detected.
      Rhinopharyngeal retrograde clearance seems to be useful in the clinical management of the
      upper airways symptoms and dysfunction in adults.
    

Detailed description: 
      The nonsmokers subjects aged 18 years to 45 years were enrolled in this study after agreement
      with the written informed consent. Subjects were randomly assigned to 15-days of one of the
      following interventions: RRC and RRC+S. Non pharmacological respiratory approaches may be
      useful in the management of the respiratory symptoms and dysfunctions air pollution-related.
      The purpose of this study was to determine whether saline instillation and/or retrograde
      rhinopharyngeal retrograde clearance are effective in the treatment of upper airways
      dysfunction through nasal mucociliary clearance, mucus properties, pH, cellularity and
      cytokines in nasal lavage and pH in exhaled breath condensate, as well as the airways
      symptoms (cough, wheeze, runny nose, hoarseness, among others) in motorcyclists due to urban
      air pollution.
    

Intervention name(s): saline and sniffing; sniffing
Intervention type(s): Other; Other
Intervention description(s): This technique is a combination of positioning (laying down), saline instilation (5 ml in each side), sniffing (the side that received saline instilation) and throat vibration. Then the other side.; This technique is a combination of positioning (laying down), sniffing (the side that received saline instilation) and throat vibration. Then the other side.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: mucociliary clearance; air pollution; nasal lavage; exhaled breath condensate; inflammation