Asia Pac Allergy.  2016 Apr;6(2):112-119. 10.5415/apallergy.2016.6.2.112.

The effects of daily bathing on symptoms of patients with bronchial asthma

Affiliations
  • 1Department of Pulmonology, National Hospital Organization Disaster Medical Center, Tokyo 190-0014, Japan. tdmckamimura@yahoo.co.jp

Abstract

BACKGROUND
The influence of bathing in asthma patients is not yet fully known.
OBJECTIVE
We conducted an observational study to investigate changes in symptoms and their degree by bathing in asthmatic patients.
METHODS
A questionnaire focusing on ever experienced bathing-induced symptom changes and their degree, as well as contributing factors, was designed and administered to asthmatic patients in the outpatient department of our institute between January 2012 and November 2013.
RESULTS
Two hundred fifteen cases were recruited. In 60 cases (27.9%), asthmatic symptoms appeared, including 20 cases of chest discomfort (33.3%), 19 cases of cough (31.7%), and 21 cases of wheezing (35.0%). The triggering factors included vapor inhalation (32 cases, 53.3%), hydrostatic pressure on the thorax due to body immersion in the bathtub (26 cases, 43.3%), and sudden change of air temperature (16 cases, 26.7%). Thirty-eight cases (17.7%) experienced improvement in active asthmatic symptoms by bathing. Vapor inhalation was the most common contributing factor (34 cases, 89.5%), followed by warming of the whole body (13 cases, 34.2%). There was no relationship between asthma severity and the appearance of bathing-induced symptoms or improvement of active asthmatic symptoms by bathing.
CONCLUSION
The effects of bathing in asthmatic patients widely differed from patient to patient and their etiology includes several factors. For those who suffer from bathing-induced asthma symptoms, preventive methods, such as premedication with bronchodilators before bathing, should be established. This study is registered in the University Hospital Medical Information Network (UMIN) clinical trials registry in Japan with the registration number UMIN000015641.

Keyword

Bronchoconstriction; Bronchodilators; Hydrostatic pressure; Inhalation; Nebulizer

MeSH Terms

Asthma*
Baths*
Bronchoconstriction
Bronchodilator Agents
Cough
Humans
Hydrostatic Pressure
Immersion
Information Services
Inhalation
Japan
Nebulizers and Vaporizers
Observational Study
Outpatients
Premedication
Respiratory Sounds
Thorax
Bronchodilator Agents

Figure

  • Fig. 1 The effects on asthma by bathing and the history of paradoxical bronchoconstriction.


Cited by  1 articles

The era of allergy
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Asia Pac Allergy. 2016;6(2):75-76.    doi: 10.5415/apallergy.2016.6.2.75.


Reference

1. Asthma Prevention and Management Guideline 2015' Creating committee. Asthma Prevention and Management Guideline 2015. Tokyo: Kyowakikaku;2015.
2. Smith CM, Anderson SD. Inhalation provocation tests using nonisotonic aerosols. J Allergy Clin Immunol. 1989; 845(Pt 1):781–790.
Article
3. Anderson SD, Smith CM. Osmotic challenges in the assessment of bronchial hyperresponsiveness. Am Rev Respir Dis. 1991; 1433(Pt 2):S43–S46.
Article
4. Rodriguez GE, Branch LB, Cotton EK. The use of humidity in asthmatic children. J Allergy Clin Immunol. 1975; 56:133–140.
Article
5. Cocchetto DM, Sykes RS, Spector S. Paradoxical bronchospasm after use of inhalation aerosols: a review of the literature. J Asthma. 1991; 28:49–53.
Article
6. Spooner LM, Olin JL. Paradoxical bronchoconstriction with albuterol administered by metered-dose inhaler and nebulizer solution. Ann Pharmacother. 2005; 39:1924–1927.
Article
7. Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M, Gibson P, Ohta K, O'Byrne P, Pedersen SE, Pizzichini E, Sullivan SD, Wenzel SE, Zar HJ. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J. 2008; 31:143–178.
Article
8. Shaw RJ, Anderson SD, Durham SR, Taylor KM, Schoeffel RE, Green W, Torzillo P, Kay AB. Mediators of hypersensitivity and "fog"-induced asthma. Allergy. 1985; 40:48–57.
Article
9. Kashiwabara K, Itonaga K, Moroi T. Airborne water droplets in mist or fog may affect nocturnal attacks in asthmatic children. J Asthma. 2003; 40:405–411.
10. Skowronski ME, Ciufo R, Nelson JA, McFadden ER Jr. Effects of skin cooling on airway reactivity in asthma. Clin Sci Lond. 1998; 94:525–529.
Article
11. Kaminsky DA, Bates JH, Irvin CG. Effects of cool, dry air stimulation on peripheral lung mechanics in asthma. Am J Respir Crit Care Med. 2000; 162:179–186.
Article
12. Leddy JJ, Roberts A, Moalem J, Curry T, Lundgren CE. Effects of water immersion on pulmonary function in asthmatics. Undersea Hyperb Med. 2001; 28:75–82.
13. Chiba T, Yamauchi M, Nishida N, Kaneko T, Yoshizaki K, Yoshioka N. Risk factors of sudden death in the Japanese hot bath in the senior population. Forensic Sci Int. 2005; 149:151–158.
Article
14. Hayes D Jr, Collins PB, Khosravi M, Lin RL, Lee LY. Bronchoconstriction triggered by breathing hot humid air in patients with asthma: role of cholinergic reflex. Am J Respir Crit Care Med. 2012; 185:1190–1196.
15. Aitken ML, Marini JJ. Effect of heat delivery and extraction on airway conductance in normal and in asthmatic subjects. Am Rev Respir Dis. 1985; 131:357–361.
16. Tranfa CM, Vatrella A, Parrella R, Bariffi F. Effect of ipratropium bromide and/or sodium cromoglycate pretreatment on water-induced bronchoconstriction in asthma. Eur Respir J. 1995; 8:600–604.
17. Keighley JF. Iatrogenic asthma associated with adrenergic aerosols. Ann Intern Med. 1966; 65:985–995.
Article
18. Schöni MH, Kraemer R. Osmolality changes in nebulizer solutions. Eur Respir J. 1989; 2:887–892.
19. Rafferty P, Beasley R, Holgate ST. Comparison of the efficacy of preservative free ipratropium bromide and Atrovent nebuliser solution. Thorax. 1988; 43:446–450.
Article
20. Wilkinson JR, Roberts JA, Bradding P, Holgate ST, Howarth PH. Paradoxical bronchoconstriction in asthmatic patients after salmeterol by metered dose inhaler. BMJ. 1992; 305:931–932.
Article
21. Agostoni E, Gurtner G, Torri G, Rahn H. Respiratory mechanics during submersion and negative-pressure breathing. J Appl Physiol. 1966; 21:251–258.
Article
22. Hong SK, Cerretelli P, Cruz JC, Rahn H. Mechanics of respiration during submersion in water. J Appl Physiol. 1969; 27:535–538.
Article
23. Galdès-Sebaldt M, McLaughlin FJ, Levison H. Comparison of cold air, ultrasonic mist, and methacholine inhalations as tests of bronchial reactivity in normal and asthmatic children. J Pediatr. 1985; 107:526–530.
Article
24. Kotaru C, Coreno A, Skowronski M, Ciufo R, McFadden ER Jr. Exhaled nitric oxide and thermally induced asthma. Am J Respir Crit Care Med. 2001; 163:383–388.
Article
25. Chen WY, Horton DJ. Airways obstruction in asthmatics induced by body cooling. Scand J Respir Dis. 1978; 59:13–20.
26. Horton DJ, Chen WY. Effects of breathing warm humidified air on bronchoconstriction induced by body cooling and by inhalation of methacholine. Chest. 1979; 75:24–28.
Article
27. Koskela HO, Koskela AK, Tukiaineu HO. Bronchoconstriction due to cold weather in COPD. The roles of direct airway effects and cutaneous reflex mechanisms. Chest. 1996; 110:632–636.
28. Gravelyn TR, Capper M, Eschenbacher WL. Effectiveness of a heat and moisture exchanger in preventing hyperpnoea induced bronchoconstriction in subjects with asthma. Thorax. 1987; 42:877–880.
Article
29. Nieminen MM, Hill M, Irvin CG. Body temperature modulates the effect of platelet-activating factor PAF. on airways responsiveness in the rabbit. Agents Actions. 1991; 32:173–181.
Article
30. Billen A, Dupont L. Exercise induced bronchoconstriction and sports. Postgrad Med J. 2008; 84:512–517.
Article
31. Lazarinis N, Jorgensen L, Ekstrom T, Bjermer L, Dahlen B, Pullerits T, Hedlin G, Carlsen KH, Larsson K. Combination of budesonide/formoterol on demand improves asthma control by reducing exercise-induced bronchoconstriction. Thorax. 2014; 69:130–136.
Article
32. Palmqvist M, Persson G, Lazer L, Rosenborg J, Larsson P, Lotvall J. Inhaled dry-powder formoterol and salmeterol in asthmatic patients: onset of action, duration of effect and potency. Eur Respir J. 1997; 10:2484–2489.
33. van der Woude HJ, Boorsma M, Bergqvist PB, Winter TH, Aalbers R. Budesonide/formoterol in a single inhaler rapidly relieves methacholine-induced moderate-to-severe bronchoconstriction. Pulm Pharmacol Ther. 2004; 17:89–95.
Article
34. Barbato A, Cracco A, Tormena F, Novello A Jr. The first 20 minutes after a single dose of inhaled salmeterol in asthmatic children. Allergy. 1995; 50:506–510.
Article
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