Hockey Players develop Chronic Cough from Zamboni Fumes

 

Teen Hockey players were starting to develop chronic cough and dyspnea with no known cause. After some investigation it was found that a poorly maintained zamboni was the cause. Local medical teams ordered a full range of tests including pulmonary function tests (PFT) including spirometry, Cardio pulmonary exercise testing (CPET) and impulse oscillometry (IOS). It was very interesting to find that 6 months after exposure IOS showed evidence of increased airway resistance and small-airway disease, which correlated with patient symptoms. This is a clear indication of the value of early and consistent pulmonary testing.

Spirometry, Lung Function test, COPD. Asthma, smoking cessation tool, www.mdspiro.com
Primary Care Physician Spirometry is the most common of the lung function tests. These tests look at how well your lungs work. Spirometry shows how well you breathe in and out. Breathing in and out can be affected by lung diseases such as chronic obstructive pulmonary disease (COPD), asthma, pulmonary fibrosis and cystic fibrosis.

Chronic cough and dyspnea in ice hockey players after an acute exposure to combustion products of a faulty ice resurfacer.

Kahan ES, Martin UJ, Spungen S, Ciccolella D, Criner GJ.

Source

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, USA. esk24@comcast.net

Spirometry, Lung Function test, COPD. Asthma, smoking cessation tool, www.mdspiro.com
Tidal breathing analysis with impulse oscillometry (IOS) has demonstrated to be informative and differentiated in the early detection and follow-up of pulmonary diseases like asthma, COPD and idiopathic pulmonary fibrosis. Therefore, IOS oscillometric airway measurements complement spirometry.

Abstract

The aim of this study was to characterize pulmonary function and radiologic testing in ice hockey players after exposure to combustion products of a faulty ice resurfacer. Our patients were 16 previously healthy hockey players who developed chronic cough and dyspnea after exposure. Symptom questionnaires, pulmonary function tests (PFTs), bronchoprovocation testing, cardiopulmonary exercise testing, high-resolution computed tomography (CT) imaging, and impulse oscillometry (IOS) were all used. A normal group was used for PFTs and IOS controls. Patients had onset of cough within 72 h of exposure. Ninety-two percent complained of dyspnea, 75% chest pain, and 33% hemoptysis. Eight percent were initially hospitalized for their symptoms. Eighty-five percent were treated with systemic steroids and 39% with inhaled bronchodilators. Six months postexposure, 54% complained of cough and 46% complained of dyspnea on exertion. All patients had normal PFTs; 8.3% had a significant bronchodilator response. All had normal exercise tests (mean VO2max = 90 +/- 3% predicted) and chest CTs. With IOS, 80% had a significant bronchodilator response (decreased resistance > 12% and SD score > 1; mean change = 21.1 +/- 9.9%, mean SD score = 3.1 +/- 2.5). No correlation existed between changes in resistance or reactance and spirometric values. Patient symptoms correlated significantly with bronchodilator response on IOS resistance (R=0.61, p=0.03). More than 50% of patients exposed to the combustion products of a faulty ice resurfacer remained symptomatic six months after exposure. Despite persistence of symptoms, conventional pulmonary function tests and radiologic evaluation did not reveal airway abnormalities. IOS showed evidence of increased airway resistance and small-airway disease, which correlated with patient symptoms.

Lung. 2007 Jan-Feb;185(1):47-54. Epub  2007 Feb 9.

Resources

http://www.carefusion.com/our-products/respiratory-care/pulmonary-function-testing/ios-spirometry

http://www.ncbi.nlm.nih.gov/pubmed/17294334

Randy Clare

Randy Clare

Randy Clare brings to The Sleep and Respiratory Scholar more than 25 years of extensive knowledge and experience in the sleep and pulmonary function field. He has held numerous management positions throughout his career and has demonstrated a unique view of the alternate care diagnostic and therapy model. He is considered by many an expert in the use of a Sleep Bruxism Monitor in a dental office. He is also very involved with physician office spirometry for the early detection of COPD and Asthma

Mr. Clare’s extensive sleep industry experience assists Sleep Scholar in providing current, relevant, data-proven information on sleep diagnostics and sleep therapies that are effective for the treatment of sleep disorders.

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