Am. J. Respir. Crit. Care Med.,
Volume 156, Number 4, October 1997, 1151-1156
Airway Responsiveness to Sulfur Dioxide in an
Adult Population Sample
DENNIS
NOWAK,
RUDOLF
JÖRRES,
JÜRGEN
BERGER,
MATTHIAS
CLAUSSEN,
and
HELGO
MAGNUSSEN
Krankenhaus Grosshansdorf, Zentrum für Pneumologie und Thoraxchirurgie, Grosshansdorf; and Universitätskrankenhaus Eppendorf,
Institut für Mathematik und Datenverarbeitung in der Medizin, Hamburg, Germany
We determined the prevalence of airway hyperresponsiveness to sulfur dioxide (SO2) in an adult population sample of 790 subjects 20 to 44 yr of age. Subjects were drawn randomly from the population of Hamburg, Northern Germany, within the framework of the European Community Respiratory
Health Survey. In addition, we analyzed the relationship between SO2 responsiveness and a number
of risk factors, such as a history of respiratory symptoms, methacholine responsiveness, and atopy derived from skin-prick test results. SO2 inhalation challenges were performed during isocapnic hyperventilation at constant rate (40 L · min
1, for 3 min) with doubling concentrations of SO2 up to a maximum concentration of 2.0 ppm. If subjects achieved a 20% decrease in FEV1 from baseline during the
challenge, they were considered to be hyperresponsive to SO2. The raw prevalence of SO2 hyperresponsiveness within the population sample studied was 3.4% (95% confidence interval [CI]: 2.3 to
5.0%). Adjustment for nonparticipation led to an estimated prevalence of SO2 hyperresponsiveness
of 5.4%. Among subjects with hyperresponsiveness to methacholine, 22.4% (95% CI: 20.1 to 25.3)
demonstrated hyperresponsiveness to SO2. There was no significant correlation between the degrees
of hyperresponsiveness to methacholine and SO2. Predictors of a positive SO2 response were hyperresponsiveness to methacholine (p < 0.0001), a positive history of respiratory symptoms (p < 0.05),
and a positive skin-prick test to at least one common allergen (p < 0.05). We conclude from these
data that airway hyperresponsiveness to SO2 can be found in about 20 to 25% of subjects within the
20- to 44-yr age range who are hyperresponsive to methacholine.