Daily variations in air pollution and respiratory health in a multicentre study: the PEACE project. Pollution Effects on Asthmatic Children in Europe

Roemer, W.; Hoek, Gerard; Brunekreef, Bert; Hałuszka, J; Kalandidi, Anna; Pekkanen, Juha

doi:10.1183/09031936.98.12061354

Cited by 83 publications

(77 citation statements)

References 22 publications

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“…A limitation of the present study is that no consistent association between particle mass (PM10 mass concentration) and respiratory health was observed. Confounding by respiratory infection may have been a cause of this lack of association in the PEACE study as a whole, and an extensive discussion of possible explanations is contained in an earlier paper [13]. Another possibility is that PM10 mass concentration was too crude an exposure indicator and that better indicators of exposure such as the concentration of soluble transition metals would reveal an association with respiratory health.…”

Section: Discussionmentioning

confidence: 99%

“…All centres used the same protocol for data collection and analysis. The design, methods and results of the individual panels [12] as well as the combined effect-estimates for PM10 and other components are reported elsewhere [13]. Each centre selected two panels, one in an urban area and one in a suburban or rural area (hereafter referred to as suburban panel).…”

Section: The Pollution Effects On Asthmatic Children In Europe Studymentioning

confidence: 99%

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PM10 elemental composition and acute respiratory health effects in European children (PEACE project)

Roemer¹,

Hoek²,

Brunekreef³

et al. 2000

Eur Respir J

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The ability of particles with a 50% cut‐off aerodynamic diameter of 10 µm (PM10) to cause respiratory health effects possibly depends on their composition. This study evaluated whether the soluble elemental concentrations in PM10 were related to acute respiratory health effects. The Pollution Effects on Asthmatic Children in Europe (PEACE) study is a multicentre study of the acute effects of PM10 and other air pollution components on the respiratory health of children with chronic respiratory symptoms in urban and suburban panels. Children, 1208, divided among 17 panels were followed for ≥2 months. Exposure to air pollution was monitored on a daily basis. Health status was monitored by twice daily peak expiratory flow (PEF) measurements and a symptom diary. Median concentrations of iron ranged 105–1,110 ng·m‐3 in the urban and 32–517 ng·m‐3 in the suburban locations. The daily concentrations of most elements were not associated with daily variation in PEF, prevalence of respiratory symptoms or bronchodilator use. Silicon and iron concentrations tended to be negatively associated with PEF, and positively associated with the prevalence of phlegm. In two pollutant models, PM10 effect‐estimates on phlegm prevalence were reduced and lost significance, whereas the effect‐estimates of iron or silicon remained essentially unchanged. The effects of silicon and iron could not be separated. In conclusion, this study provides only weak support for the hypothesis that daily fluctuations in soluble elemental concentrations in ambient particulate matter are responsible for acute health effects.

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Section: Discussionmentioning

confidence: 99%

Section: The Pollution Effects On Asthmatic Children In Europe Studymentioning

confidence: 99%

PM10 elemental composition and acute respiratory health effects in European children (PEACE project)

Roemer¹,

Hoek²,

Brunekreef³

et al. 2000

Eur Respir J

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“…They have some limitations, which were discussed in detail in a previous paper [6]. To date, most panel studies on asthmatic children have been conducted in winter [8,[13][14][15][16][17][18], with few focusing on the effects of spring and summer air pollution. Two studies were conducted in Los Angeles, CA, USA.…”

Section: Discussionmentioning

confidence: 99%

Short-term health effects of particulate and photochemical air pollution in asthmatic children

Just¹,

Ségala²,

Sahraoui³

et al. 2002

European Respiratory Journal

101

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In a previous panel study in Paris, France, detrimental effects of moderately high levels of winter air pollution on the symptoms and lung function of asthmatic children were demonstrated. A new study was conducted, with the aim of assessing the short-term effects of photo-oxidant and particulate air pollution on childhood asthma during spring and early summer in Paris.Eighty-two medically diagnosed asthmatic children were followed up for 3 months. Outcomes included the incidence and prevalence of asthma attacks, nocturnal cough, supplementary use of b 2 -agonists, symptoms of airway irritation, and peak expiratory flow (PEF) value and its variability. The statistical methods controlled for the lack of independence between daily health outcomes, temporal trends and pollen and weather conditions.Black smoke and nitrogen dioxide (NO 2 ) were associated with increases in the occurrence of nocturnal cough and respiratory infections. Ozone (O 3 ) was associated with an increase in the occurrence of asthma attacks and respiratory infections and with changes in lung function, as shown by an increase in PEF variability and a decrease in PEF. Statistically significant interactions were demonstrated between O 3 and temperature and between O 3 and pollen count for asthma attacks. O 3 levels had a greater effect on additional bronchodilator use and on irritations of the eyes, nose and throat on days on which no steroids were used. Particulate matter was associated with eye irritation only.This study showed that, although within international air quality standards, the prevailing levels of photo-oxidant and particulate pollution in spring and early summer had measurable short-term effects on children with mild-to-moderate asthma. Eur Respir J 2002; 20: 899-906 The short-term effects of air pollution in humans are predominantly assessed by means of time series studies. These recently reviewed [1] studies have shown broadly consistent associations between air pollutants and a number of related outcomes, such as total mortality, cardiorespiratory mortality and hospital admissions. To ensure that relationships observed are causal, it is necessary to check that studies with different designs show similar associations [2] and that there is coherence between a broad range of related health outcomes [3]. As recently reviewed [4,5], panel studies provide these advantages. The health effects are measured on an individual basis, whereas the exposure data are mostly based on aggregated data. These studies are often conducted on the most susceptible subgroups of the population, such as children and asthmatics. Previously, a panel study was conducted in Paris, France [6], in which the detrimental effect of moderately high levels of winter air pollution on the symptoms and lung function of asthmatic children was demonstrated. As attention is increasingly focused on photo-oxidant air pollution episodes, a new study was conducted with the aim of assessing the short-term effects of photo-oxidant and particulate pollution on the heal...

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“…The methods of the Pollution Effects on Asthmatic Children in Europe (PEACE) study were used to analyse the association between air pollution and respiratory health [27,28]. Here only a brief overview and the deviations are discussed.…”

Section: Discussionmentioning

confidence: 99%

“…For the analysis of PEF data, the daily prevalence of 10% and 20% decrements below the individual median of morning and evening PEF were analysed [29]. The authors preferred this method to the analysis of population mean PEF [27,28] because it demonstrates better the clinical significance of PEF associations. The explanatory variables were 24 h average concentration of PM10, BS, SO 2 , NO 2 sulphate and nitrate, analysed separately.…”

Section: Discussionmentioning

confidence: 99%

Acute effects of air pollution on respiratory health of 50-70 yr old adults

et al. 2000

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The aim of this study was to investigate the association between daily changes in respiratory health and air pollution in 489 adults, aged 50±70 yrs, with and without chronic respiratory symptoms, living in urban and nonurban areas in the Netherlands.Subjects were selected from the general population with a screening questionnaire. During three consecutive winters starting in 1992/1993, peak expiratory flow (PEF) and respiratory symptoms were registered in a daily diary. Daily measurements of particles with a 50% cut-off aerodynamic diameter of 10 mm (PM10), black smoke (BS), sulphate, sulphur dioxide (SO 2 ) and nitrogen dioxide (NO 2 ) were conducted. The difference in PM10, BS and sulphate concentrations between urban and nonurban areas was small, but there was more contrast in the concentrations of SO 2 and NO 2 .In symptomatic subjects from urban areas, PM10, BS, sulphate and SO 2 concentrations were associated with the prevalence of large decrements in morning PEF (>20% below the median). BS in particular was also associated with upper respiratory symptoms (URS). The magnitude of the effect estimates was in the order of an 80% increase in PEF decrements and a 20% increase in URS for a 40 mg . m -3 increase of the same day BS concentration. In symptomatic subjects from nonurban areas, no consistent associations between air pollution and health indicators were observed. However, the differences in effect estimates between urban and nonurban symptomatic panels were small and nonsignificant. In nonsymptomatic adults from both areas, no consistent pattern of associations with air pollution was found.In conclusion, air pollution effects were only found in symptomatic adults in the urban areas. Eur Respir J 2000; 15: 700±709.

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Daily variations in air pollution and respiratory health in a multicentre study: the PEACE project. Pollution Effects on Asthmatic Children in Europe

Cited by 83 publications

References 22 publications

PM10 elemental composition and acute respiratory health effects in European children (PEACE project)

PM10 elemental composition and acute respiratory health effects in European children (PEACE project)

Short-term health effects of particulate and photochemical air pollution in asthmatic children

Acute effects of air pollution on respiratory health of 50-70 yr old adults

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