Childhood respiratory symptoms, hospital admissions, and long-term exposure to airborne particulate matter

Abstract

The effects of long -term exposure to air pollution on respiratory symptoms and respiratory hospitalization ( for asthma, bronchitis or pneumonia ) were assessed in a cross -sectional study of children ( ages 7 ± 11 years, N = 667 ) living in a moderately industrialized city in Central Slovakia. Individual health, residence and family history data obtained through the CESAR study were coupled, using Geographic Information System ( GIS ) technologies, with total suspended particulate ( TSP ) exposure estimates derived from dispersion modeling of almost all local stationary sources. These data were used to assess, at the intra -city level and child -specific level, the potential for TSP as a risk factor for respiratory disease in children. TSP, PM 10 , and PM 2.5 monitored ambient concentrations are highly correlated in the study location. Modeled TSP concentrations resulting from local source emissions are dominated by a large wood processing facility, suggesting variation in exposures among children. The prevalence of respiratory non -asthmatic symptoms and hospitalizations was associated with increased TSP. No association between long -term exposure to TSP and asthma diagnosis or wheeze symptoms was found. Logistic regression modeling indicated a significant increase in hospital admissions for asthma, bronchitis or pneumonia associated with increasing air pollution ( OR 2.16, CI, 1.01 ± 4.60 ) , doctor -diagnosed bronchitis ( OR 1.53, CI, 1.02 ± 2.30 ) , and parent -reported chronic phlegm ( OR 3.43, CI, 1.64 ± 7.16 ) , expressed as odds for a 15 g / m 3 increase in estimated TSP exposure, and these increases are not due to differences in socio -economic, health care or other identified factors.

Children's respiratory morbidity prevalence in relation to air pollution in four Chinese cities.

“…The early Harvard Six Cities Study found that a number of respiratory morbidity outcomes in schoolchildren (cough or persistent cough, bronchitis, chest illness, wheeze, and/or lower respiratory illness index) were positively associated with ambient particulate (measured as TSP) levels (16,22). A more recent Slovakian study has also found that the prevalence of respiratory nonasthmatic symptoms and hospitalizations was associated with increased TSP (17).…”

“…The prevalence of persistent cough in children reported in the three North American studies was 3-9% (11,12,14); in the Switzerland study it was 4.7-19.2% (13); and in the Slovakian study it was 24.9% (17). The prevalence of persistent phlegm in children reported in one of the three North American studies was 1-5% (12) and in the Slovakian study was 5.1% (17). The prevalence of bronchitis and the prevalence of persistent cough in children appeared to be markedly higher in the Chinese and Slovakian cities where ambient pollution levels were also higher.…”

“…After adjusting for all the covariates listed in Table 2, the district-specific prevalence of wheeze was 6.6-18.8%; asthma, 1.4-4.2%; bronchitis, 15.6-52.2%; hospitalization due to respiratory diseases, 7.7-26.7%; persistent cough, 5.7-14%; and persistent phlegm, 1.9-13.6% (Table 3). For comparison, the prevalence of wheeze in children reported in three studies in North America was 4-23% (11,12,14,16); in a study in Switzerland it was 3.7-9.1% (13); and in a study in Slovakia it was 10.6% (17). The prevalence of asthma in children reported in the three North American studies was 3-14.5% (11,12,14,16); in the Switzerland study and an Italian study it was 5.1-10.6% (13,18); and in the Slovakia study it was 3.9% (17).…”

“…For comparison, the prevalence of wheeze in children reported in three studies in North America was 4-23% (11,12,14,16); in a study in Switzerland it was 3.7-9.1% (13); and in a study in Slovakia it was 10.6% (17). The prevalence of asthma in children reported in the three North American studies was 3-14.5% (11,12,14,16); in the Switzerland study and an Italian study it was 5.1-10.6% (13,18); and in the Slovakia study it was 3.9% (17). The prevalence of bronchitis in children reported in three North American studies was 3.6-13.1% (11,12,14); in the Switzerland study it was 5.7-27% (13); and in the Slovakian study it was 58.8% (17).…”

Personal exposure to particles in Banská Bystrica, Slovakia

“…There is a population of approximately 13,000 residents living in the Sasova complex, a suburban residential area of 15-story apartment blocks about 3 km away from the city center and 250 m higher in elevation. Major industries include a large wood processing facility near the city center and a cement plant located 5 km from the city center (Hruba et al, 2000 ) . Local heating sources rely primarily on natural gas.…”