Cold air-provoked respiratory symptoms: the mechanisms and management

Abstract

Objectives. To describe the mechanisms and management of cold air-provoked respiratory symptoms.

Study Design. A literature review.

Methods. The review includes human epidemiological studies, human and animal experimental studies, as well as human studies about management of the cold air-provoked respiratory symptoms.

Results. Cold air is unlikely to be a causal factor initiating respiratory diseases but a symptom trigger. In the present review, the airway responses beyond these symptoms were divided into three types. The short-term responses are those that develop within minutes in response to sudden cooling of the airways. Subjects with asthma or rhinitis are especially prone to these responses. The long-term responses are those that develop in response to repeated and long-standing cooling and drying of the airways, usually in endurance athletes. Finally, there are the physiological, reflex-mediated lower-airway responses to cooling of the skin or upper airways.

Conclusions. The mechanisms beyond cold air-provoked respiratory symptoms vary considerably and mainly depend on the individual`s susceptibility and the ventilation level during the cold exposure. An understanding of these mechanisms is essential for successful management of the symptoms.

Keywords:

• cold climate
• signs and symptoms
• respiratory
• rhinitis
• asthma
• chronic obstructive pulmonary disease