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PLoS By Category | Recent PLoS Articles
Infectious Diseases - Pediatrics and Child Health - Public Health and Epidemiology - Respiratory Medicine

Effect of Temperature on Cystic Fibrosis Lung Disease and Infections: A Replicated Cohort Study
Published: Friday, November 18, 2011
Author: Joseph M. Collaco et al.

by Joseph M. Collaco, John McGready, Deanna M. Green, Kathleen M. Naughton, Christopher P. Watson, Timothy Shields, Scott C. Bell, Claire E. Wainwright, for the ACFBAL Study Group, Garry R. Cutting3

Background

Progressive lung disease accounts for the majority of morbidity and mortality observed in cystic fibrosis (CF). Beyond secondhand smoke exposure and socio-economic status, the effect of specific environmental factors on CF lung function is largely unknown.

Methods

Multivariate regression was used to assess correlation between specific environmental factors, the presence of pulmonary pathogens, and variation in lung function using subjects enrolled in the U.S. CF Twin and Sibling Study (CFTSS: n?=?1378). Significant associations were tested for replication in the U.S. CF Foundation Patient Registry (CFF: n?=?16439), the Australian CF Data Registry (ACFDR: n?=?1801), and prospectively ascertained subjects from Australia/New Zealand (ACFBAL: n?=?167).

Results

In CFTSS subjects, the presence of Pseudomonas aeruginosa (OR?=?1.06 per °F; p<0.001) was associated with warmer annual ambient temperatures. This finding was independently replicated in the CFF (1.02; p<0.001), ACFDR (1.05; p?=?0.002), and ACFBAL (1.09; p?=?0.003) subjects. Warmer temperatures (-0.34 points per °F; p?=?0.005) and public insurance (-6.43 points; p<0.001) were associated with lower lung function in the CFTSS subjects. These findings were replicated in the CFF subjects (temperature: -0.31; p<0.001; insurance: -9.11; p<0.001) and similar in the ACFDR subjects (temperature: -0.23; p?=?0.057). The association between temperature and lung function was minimally influenced by P. aeruginosa. Similarly, the association between temperature and P. aeruginosa was largely independent of lung function.

Conclusions

Ambient temperature is associated with prevalence of P. aeruginosa and lung function in four independent samples of CF patients from two continents.

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