Subjects with seasonal allergic rhinitis and nonrhinitic subjects react differentially to nasal provocation with chlorine gas Dennis J. Shusterman, MD,

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Subjects with seasonal allergic rhinitis and nonrhinitic subjects react differentially to nasal provocation with chlorine gas Dennis J. Shusterman, MD, MPH a, Mary Alice Murphy, MD, MPH b, John R. Balmes, MDa Journal of Allergy and Clinical Immunology Volume 101, Issue 6, Pages 732-740 (June 1998) DOI: 10.1016/S0091-6749(98)70302-1 Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 1 Overall study design for chlorine provocation. Study was counterbalanced with respect to both gender and order of exposure (i.e., equal numbers of male and female rhinitic and nonrhinitic subjects were exposed to air or chlorine first). Journal of Allergy and Clinical Immunology 1998 101, 732-740DOI: (10.1016/S0091-6749(98)70302-1) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 2 Schematic of chlorine dilution apparatus. Note that exposure was by nasal mask with scavenger hose attached to T-piece, allowing subject to transition from exposure to physiologic testing without leaving climate-controlled chamber. CPAP, Continuous positive airway pressure. Journal of Allergy and Clinical Immunology 1998 101, 732-740DOI: (10.1016/S0091-6749(98)70302-1) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 3 Net percent change in nasal airway resistance (from baseline) ± SEM (chlorine minus air condition) for postexposure times 1 and 2 by rhinitis status (p < 0.05 by ANOVA at both testing times). Journal of Allergy and Clinical Immunology 1998 101, 732-740DOI: (10.1016/S0091-6749(98)70302-1) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 4 Paired analyses of percent change in nasal airway resistance (from baseline) stratified by rhinitis status and time ( p < 0.05 by paired t test for rhinitic subjects only at both testing times). Journal of Allergy and Clinical Immunology 1998 101, 732-740DOI: (10.1016/S0091-6749(98)70302-1) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 5 Symptom ratings by time stratified by rhinitis status (1 = slight and 2 = moderate). Significant elevations were apparent, comparing chlorine and air exposures, for odor intensity (p < 0.01 at end of exposure for rhinitic subjects and p < 0.05 for nonrhinitic subjects), nasal irritation (p < 0.05 at end of exposure for rhinitic subjects only), and nasal congestion (p < 0.05 at 15 minutes after exposure for rhinitic subjects only). Journal of Allergy and Clinical Immunology 1998 101, 732-740DOI: (10.1016/S0091-6749(98)70302-1) Copyright © 1998 Mosby, Inc. Terms and Conditions