With fewer newborns and people living longer, older people are making up an increasing fraction of the total population. Epidemiological evidence shows that older-age-related health problems affect a wide and expanding proportion of the world population. One of the major epidemiological trends of this century is the rise of chronic diseases that affect more elderly than younger people. A total of 3.7 million premature deaths worldwide in 2012 are attributable to outdoor air pollution; the susceptibility to adverse effects of air pollution is expected to differ widely between people and within the same person, and also over time. Frailty history, a measure of multi-system decline, modifies cumulative associations between air pollution and lung function. Moreover, pre-existing diseases may determine susceptibility. In the elderly, due to comorbidity, exposure to air pollutants may even be fatal. Rapid and not-well-planned urbanization is associated with high level of ambient air pollution, mainly caused by vehicular exhausts. In general, there is sufficient evidence of the adverse effects related to short-term exposure, while fewer studies have addressed the longer-term health effects. Increased pollution exposures have been associated with increased mortality, hospital admissions/emergency-room visits, mainly due to exacerbations of chronic diseases or to respiratory tract infections (e.g., pneumonia). These effects may also be modulated by ambient temperature and many studies show that the elderly are mostly vulnerable to heat waves. The association between heat and mortality in the elderly is well-documented, while less is known regarding the associations with hospital admissions. Chronic exposure to elevated levels of air pollution has been related to the incidence of chronic obstructive pulmonary disease (COPD), chronic bronchitis (CB), asthma, and emphysema. There is also growing evidence suggesting adverse effects on lung function related to long-term exposure to ambient air pollution. Few studies have assessed long-term mortality in the elderly. It is still unclear what are the pollutants most damaging to the health of the elderly. It seems that elderly subjects are more vulnerable to particulate matter (PM) than to other pollutants, with particular effect on daily cardio-respiratory mortality and acute hospital admissions. Not many studies have targeted elderly people specifically, as well as specific respiratory morbidity. Most data have shown higher risks in the elderly compared to the rest of the population. Future epidemiological cohort studies need to keep investigating the health effects of air pollutants (mainly cardiopulmonary diseases) on the elderly.

Controls for indoor air quality (IAQ) in schools are not usually performed throughout Europe. The aim of this study was to assess the effects of IAQ on respiratory health of schoolchildren living in Norway, Sweden, Denmark, France and Italy.In the cross-sectional European Union-funded HESE (Health Effects of School Environment) Study, particulate matter with a 50% cut-off aerodynamic diameter of 10 µm (PM₁₀) and CO₂levels in a day of normal activity (full classroom) were related to wheezing, dry cough at night and rhinitis in 654 children (10 yrs) and to acoustic rhinometry in 193 children.Schoolchildren exposed to PM₁₀>50 μg·m⁻³and CO₂>1,000 ppm (standards for good IAQ) were 78% and 66%, respectively. All disorders were more prevalent in children from poorly ventilated classrooms. Schoolchildren exposed to CO₂levels >1,000 ppm showed a significantly higher risk for dry cough (OR 2.99, 95% CI 1.65–5.44) and rhinitis (OR 2.07, 95% CI 1.14–3.73). By two-level (child, classroom) hierarchical analyses, CO₂was significantly associated with dry cough (OR 1.06, 95% CI 1.00–1.13 per 100 ppm increment) and rhinitis (OR 1.06, 95% CI 1.00–1.11). Nasal patency was significantly lower in schoolchildren exposed to PM₁₀>50 μg·m⁻³than in those exposed to lower levels.A poor IAQ is frequent in European classrooms; it is related to respiratory disturbances and affects nasal patency.

Early diagnosis and continuous monitoring of respiratory failure (RF) in the course of the most prevalent chronic cardio-vascular (CVD) and respiratory diseases (CRD) are a clinical, unresolved problem because wearable, non-invasive, and user-friendly medical devices, which could grant reliable measures of the oxygen saturation (SpO₂) and heart rate (HR) in real-life during daily activities are still lacking. In this study, we investigated the agreement between a new medical wrist-worn device (BrOxy M) and a reference, medical pulseoximeter (Nellcor PM 1000N). Twelve healthy volunteers (aged 20–51 years, 84% males, 33% with black skin, obtaining, during the controlled hypoxia test, the simultaneous registration of 219 data pairs, homogeneously deployed in the levels of Sat.O₂ 97%, 92%, 87%, 82% [ISO 80601-2-61:2017 standard (paragraph EE.3)]) were included. The paired T test 0 and the Bland-Altman plot were performed to assess bias and accuracy. SpO₂ and HR readings by the two devices resulted significantly correlated (r = 0.91 and 0.96, p < 0.001, respectively). Analyses excluded the presence of proportional bias. For SpO₂, the mean bias was −0.18% and the accuracy (A_RMS) was 2.7%. For HR the mean bias was 0.25 bpm and the A_RMS3.7 bpm. The sensitivity to detect SpO₂ ≤ 94% was 94.4%. The agreement between BrOxy M and the reference pulse oximeter was “substantial” (for SpO₂ cut-off 94% and 90%, k = 0.79 and k = 0.80, respectively). We conclude that BrOxy M demonstrated accuracy, reliability and consistency in measuring SpO₂ and HR, being fully comparable with a reference medical pulseoxymeter, with no adverse effects. As a wearable device, Broxy M can measure continually SpO₂ and HR in everyday life, helping in detecting and following up CVD and CRD subjects.