Emergency Room Visits of Asthmatic Children, Relation to Air Pollution, Weather, and Airborne Allergens

Garty, Ben Zion; Kosman, Evsey; Ganor, E.; Bérger, Víctor Valentín Pagola; Garty, Limor; Wietzen, Tova; Waisman, Yesheskel; Mimouni, M.; Waisel, Yozv

doi:10.1016/s1081-1206(10)62707-x

Cited by 121 publications

(84 citation statements)

References 29 publications

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“…In Vancouver, BATES et al [37] observed an association between this pollutant and asthma-related emergency visits among subjects aged w15 yrs. ROSSI et al [23] also observed positive results, as did other recent studies in Birmingham [38], Tel Aviv [39], London [26] and Belfast [27], where a statistically significant relationship was detected with current-or previous-day pollutant levels. Against this, other studies [22,29,35,40,41] have failed to demonstrate asthma-related effects.…”

Section: 80supporting

confidence: 52%

Short-term effects of air pollution on daily asthma emergency room admissions

Galán¹,

Tobías²,

Banegas³

et al. 2003

Eur Respir J

167

120

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Many time-series studies have shown positive associations between air pollutants and asthma morbidity. However, few studies have included pollen as a potential confounder when examining this relationship.This study analysed the short-term association between air pollutants (sulphur dioxide (SO 2 ), particles measured with a median aerodynamic diameter of v10 mm (PM10), nitrogen dioxide (NO 2 ) and ozone (O 3 )) and asthma emergency room admissions in Madrid, Spain, in 1995-1998, adjusting for four types of pollen with allergenic potential (Olea europaea, Plantago sp., Poaceae and Urticaceae). Data were analysed using autoregressive Poisson regression and generalised additive models (GAM).The strongest associations were observed at 1 day lag for O 3 , and 3 days lag for the remaining pollutants. Using Poisson regression, a single-pollutant model showed that a 10-mg?m -3 rise in pollutant level led to relative risks of: 1.039 for PM10; 1.029 for SO 2 ; 1.033 for NO 2 ; and 1.045 for O 3 . Adjustment for the different types of pollen led to no substantial variation in these associations. In the multipollutant models for cold-season pollutants (including PM10, SO 2 and the four types of pollen) and photochemical pollutants (including NO 2 , O 3 and the four types of pollen) the associations for PM10, NO 2 and O 3 held, but no relationship with SO 2 was evident. GAM analysis yielded the same results, both in terms of lags and of quantification of the effect for all pollutants.In conclusion, the usual air pollution levels in Madrid were associated with an increase in asthma emergency room admissions, and this association remained controlling for the presence of ambient pollen. Eur Respir J 2003; 22: 802-808.

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Section: 80supporting

confidence: 52%

Short-term effects of air pollution on daily asthma emergency room admissions

Galán¹,

Tobías²,

Banegas³

et al. 2003

Eur Respir J

167

120

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“…The geographic differences in asthma rates may be explained by the higher altitude of the Northern and Jerusalem districts, and by different levels of air pollutants in these districts [24]. An association between asthma morbidity and levels of air pollutants was reported in the Haifa and Tel Aviv districts [25,26].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of asthma in 13-14 yr-old schoolchildren across Israel

et al. 2000

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There is evidence that the incidence and severity of asthma are increasing worldwide, but there are limited data on asthma in Israel. The aim of this study was to investigate the prevalence and severity of asthma and asthma symptoms in 13±14 yr-old schoolchildren in Israel.The self-completed questionnaire used was a modified version of that developed by the International Study of Asthma and Allergies in Childhood (ISAAC), and was administered to a national sample of 12,918 children.The prevalence of asthma ever, wheezing ever and wheezing in the last 12 months were 13.7, 23.8 and 17.9% respectively. Significantly higher rates of a history of asthma and asthma symptoms were observed in Jews compared with Arabs. Although asthma ever was more prevalent in males than in females, asthma symptoms were significantly more common in females. The type of area of residence had no effect on the prevalence of wheezing. The ethnic differences in the prevalence of asthma persisted after controlling for sex, district of residence and level of urbanization.The prevalence of both asthma and asthma symptoms in Israel are slightly above the mean reported from 10 other countries in Europe and the Far-East. Eur Respir J 2000; 15: 725±729.

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“…barometric pressure, temperature and humidity) in triggering and/or exacerbating respiratory allergic symptoms in predisposed subjects is still poorly understood [14] and asthma attacks have been linked with both low [36] and high [155] atmospheric pressure. In other words, studies are required to clarify the role of weather in morbidity and mortality for respiratory allergy [156,157].…”

Section: Plant-derived Allergensmentioning

confidence: 99%

Outdoor air pollution, climatic changes and allergic bronchial asthma

D’Amato¹,

Liccardi²,

D’Amato³

et al. 2002

European Respiratory Journal

221

158

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Both the prevalence and severity of respiratory allergic diseases such as bronchial asthma have increased in recent years. Among the factors implicated in this "epidemic" are indoor and outdoor airborne pollutants. Urbanisation with its high levels of vehicle emissions and Westernised lifestyle parallels the increase in respiratory allergy in most industrialised countries, and people who live in urban areas tend to be more affected by the disease than those of rural areas. In atopic subjects, exposure to air pollution increases airway responsiveness to aeroallergens. Pollen is a good model with which to study the interrelationship between air pollution and respiratory allergic diseases. Biological aerosols carrying antigenic proteins, such as pollen grains or plantderived paucimicronic components, can produce allergic symptoms. By adhering to the surface of these airborne allergenic agents, air pollutants could modify their antigenic properties. Several factors influence this interaction, i.e., type of air pollutant, plant species, nutrient balance, climatic factors, degree of airway sensitisation and hyperresponsiveness of exposed subjects. However, the airway mucosal damage and the impaired mucociliary clearance induced by air pollution may facilitate the penetration and the access of inhaled allergens to the cells of the immune system, and so promote airway sensitisation. As a consequence, an enhanced immunoglobulin E-mediated response to aeroallergens and enhanced airway inflammation favoured by air pollution could account for the increasing prevalence of allergic respiratory diseases in urban areas.

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Emergency Room Visits of Asthmatic Children, Relation to Air Pollution, Weather, and Airborne Allergens

Cited by 121 publications

References 29 publications

Short-term effects of air pollution on daily asthma emergency room admissions

Short-term effects of air pollution on daily asthma emergency room admissions

Prevalence of asthma in 13-14 yr-old schoolchildren across Israel

Outdoor air pollution, climatic changes and allergic bronchial asthma

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