Comparison of the Fractional Exhaled Nitric Oxide Levels in Adolescents at Three Schools Located Three Different Distances from a Large Steel Mill

Abstract

Objectives. Exposure to ambient metals and air pollutants in urban environments has been associated with impaired lung health and inflammation in the lungs. Fractional exhaled nitric oxide (FeNO) is a reliable marker of airway inflammation. In this study, we aimed to compare the FeNO levels of three schools that have different distances from iron and steel industry zone for assessing the effects of heavy metals and air pollution on their respiratory health. Methods. Pulmonary function test and FeNO measurements were evaluated in 387 adolescents in three schools which have different distance from plant. Results. FeNO levels were significantly higher in School I (n = 142; 18.89 ± 12.3 ppb) and School II (n = 131; 17.68 ± 7.7 ppb) than School III (n = 114; 4.28 ± 3.9 ppb). Increased FeNO concentration was related to the distance of iron and steel industry zone in young adults. Conclusion. The FeNO concentrations in school children were inversely proportional to the distance from the steel mill. There are needed some studies that can evaluate the safe distance and legislation must consider these findings.

Respiratory

“…Steel processing is known to be a source of ambient iron, nickel, lead, copper, vanadium, and zinc. The study found statistically significant differences in FeNO between the two closer schools compared to the farthest school from the mill, indicating potential increased lung inflammation caused by heavy metals and/or air pollutants [127].…”

“…A 2016 study published in the Canadian Respiratory Journal examined exhaled fractional nitric oxide (FeNO)an indicator of inflammation in the lungs -in school children at three different schools located three different distances from a large steel mill [127]. Steel processing is known to be a source of ambient iron, nickel, lead, copper, vanadium, and zinc.…”

Long-term Exposures to Air Pollutants Affect FeNO in Children: A Longitudinal Study

“…In 241 healthy, full-term infants, prenatal average NO 2 from a central monitoring site was associated with increased FeNO measured during sleep at five weeks of age, even after adjusting for mean NO 2 in the 2 days prior to the FeNO test or residential distance to major road. 9 Two studies relating FeNO to proximity to industrial activity found FeNO to be elevated in children living closer to oil refinery/petrochemical activity 6 and in children attending schools closer to a steel mill, 7 though neither study adjusted for short-term air pollution exposures. Three studies 5, 8, 27 found a similar magnitude positive association between a proxy measure for traffic exposure (length of road in a circular buffer around the home), with the strongest associations for the smallest buffers around the home.…”

“…For example, a number of cross-sectional studies have related FeNO to either location-based proxies for long-term exposures to traffic/industrial activity or long-term (seasonal to annual average) ambient pollution. Some of these studies found significant positive associations 5-7 (two with adjustment for short-term exposures 8, 9 ) but others did not. 10-15 An early analysis of CHS data over a short follow-up period is one of the few studies to date relating longitudinally assessed FeNO to long-term ambient air pollution exposures.…”

The Impact of Exposure to Indoor Pollutants on Allergy and Lung Inflammation among School Children in Selangor, Malaysia: An Evaluation Using Factor Analysis

“…FeNO levels determination is a non-invasive, fast and cheap technique, and an acceptable surrogate biomarker of airway inflammation (Kim et al, 2016;Zissler et al, 2016). Previous epidemiological studies have found association between FeNO levels with the air pollutants concentrations in the classrooms (Grutta et al, 2012;Acat et al, 2017). This relationship is commonly analysed using robust regression analysis.…”