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Physiological and pathological changes in lung conductive airways can be studied in clinical pulmonary laboratories using noninvasive measurements of particle deposition efficiency and rates of mucociliary clearance. These techniques, reviewed herein, can provide very sensitive indices of (1) the average effective sizes of small airways, (2) the presence of airway obstructions, and (3) defects in clearance function. Serial measurements in the same individuals can be used to determine responses to and recovery from short-term exposures to airborne chemicals. The aerosol techniques provide evidence for physiological responses to irritants such as cigarette smoke and submicrometre-sized droplets of sulfuric acid at exposures which, in many cases, are much lower than needed to produce changes in respiratory mechanical function. Furthermore, transient changes in mucociliary clearance function following single exposures in humans and animals lead to persistent changes in function and airway structure after repetitive exposures of animals. Thus, aerosol techniques should be more widely utilized in clinical pulmonary studies on criteria pollutants.
particle deposition, mucociliary clearance, conductive airways, chronic obstructive lung disease, monodisperse aerosols, aerosol probes, airway obstruction, chronic bronchitis, noninvasive function tests, air pollution, inhalation toxicology
Professor, New York University Medical Center, Institute of Environmental Medicine, Tuxedo, NY