Am. J. Respir. Crit. Care Med., Volume 158, Number 1, July 1998, 226-232

Antioxidant Supplementation and Respiratory Functions among Workers Exposed to High Levels of Ozone

ISABELLE ROMIEU, FERNANDO MENESES, MATIANA RAMIREZ, SILVIA RUIZ, ROGELIO PEREZ PADILLA, JUAN JOSE SIENRA, MARIETTE GERBER, LINDA GRIEVINK, RIENEKE DEKKER, INGRID WALDA, and BERT BRUNEKREEF

Pan American Health Organization; Instituto Nacional de Salud Publica, Cuernavaca, Mor; Instituto de Investigacion en Matematica Aplicada y Sistemas, Universidad Autonoma de Mexico, Mexico DF; Instituto de Enfermedades Respiratorias, Mexico DF; Hospital Infantil de Mexico, Federico Gomez, Mexico DF, Mexico; INSERM-CRLC, Groupe d'epidemiologic metabolique, Montpellier, France; and Department of Environmental Sciences, Environmental and Occupational Health Group, Wageningen Agricultural University, The Netherlands

Ozone exposure has been related to adverse respiratory effects, in particular to lung function decrements. Antioxidant vitamins are free-radical scavengers and could have a protective effect against photo-oxidant exposure. To evaluate whether acute effects of ozone on lung functions could be attenuated by antioxidant vitamin supplementation, we conducted a randomized trial using a double-blind crossover design. Street workers (n = 47) of Mexico City were randomly assigned to take daily a supplement (75 mg vitamin E, 650 mg vitamin C, 15 mg beta carotene) or a placebo and were followed from March to August 1996. Pulmonary function tests were done twice a week at the end of the workday. During the follow-up, the mean 1-h maximum ozone level was 123 ppb (SD = 40). During the first phase, ozone levels were inversely associated with FVC (beta = 1.60 ml/ppb), FEV₁ (beta = 2.11 ml/ppb), and FEF_25-75 (beta = 4.92 ml/ppb) (p < 0.05) in the placebo group but not in the supplement group. The difference between the two groups was significant for FVC, FEV₁, and FEF_25-75 (p < 0.01). During the second phase, similar results were observed, but the lung function decrements in the placebo group were smaller, suggesting that the supplementation may have had a residual protective effect on the lung. These results need to be confirmed in larger supplementation studies.

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